Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave 57., Szeged H-6725, Hungary.
Department of Psychiatry, Faculty of Medicine, University of Szeged, Kálvária Ave 57., Szeged H-6725, Hungary.
J Affect Disord. 2018 Aug 1;235:583-588. doi: 10.1016/j.jad.2018.04.082. Epub 2018 Apr 16.
The significance of decision-making in suicidal behaviour is often highlighted; however, the performance of persons in suicide crisis is unknown. This study aimed to explore the comprehensive decision-making profile of depressed patients following a suicide attempt.
Decision-making was measured by reward- ("ABCD") and punishment- ("EFGH") sensitive versions of the Iowa Gambling Task (IGT) in 59 medication-free depressed patients within 72 h after a suicide attempt and in 46 healthy control subjects. Severity of depressive symptoms was assessed in the patient group by the Hamilton Depression Rating Scale.
Performance of the two groups differed significantly on the IGT ABCD, while a trend towards significant differences was seen on the IGT EFGH. Severity of depressive symptoms did not affect the depressed participants' decision-making performance.
Subjects were not matched for years of education. Administration of the IGT ABCD and IGT EFGH was not counterbalanced. Methods of suicide attempts and history of previous attempts were not collected.
Individuals with a recent suicide attempt showed decision-making dysfunction on both IGT versions. However, on the EFGH, the overall difference between groups was not significant, depressed participants' performance remained poor during all blocks. Their behaviour reflected a focus on best immediate possible outcomes, not regarding future adverse consequences. This could be a result of psychological and cognitive alterations which modulate suicidal behaviour independent from mood. Further longitudinal studies should verify this possibility. Investigation of state-dependent neuropsychological characteristics of suicidal behaviour might be essential for detecting acute suicidal crisis.
决策在自杀行为中的重要性经常被强调；然而，处于自杀危机中的人的表现却不得而知。本研究旨在探讨自杀未遂后抑郁患者的综合决策特征。
在自杀未遂后 72 小时内，对 59 名未服用药物的抑郁患者和 46 名健康对照者使用奖励敏感版（“ABCD”）和惩罚敏感版（“EFGH”）的爱荷华赌博任务（IGT）测量决策能力。患者组的抑郁严重程度采用汉密尔顿抑郁评定量表进行评估。
两组在 IGT ABCD 上的表现存在显著差异，而在 IGT EFGH 上则存在显著差异的趋势。抑郁症状的严重程度并未影响抑郁患者的决策表现。
受试者未按受教育年限进行匹配。IGT ABCD 和 IGT EFGH 的施测未进行平衡。未收集自杀尝试的方法和以往尝试的历史。
最近有自杀企图的个体在两个 IGT 版本上都表现出决策功能障碍。然而，在 EFGH 上，两组之间的总体差异不显著，抑郁参与者在所有阶段的表现仍然很差。他们的行为反映了对最佳即时结果的关注，而不考虑未来的不利后果。这可能是调节自杀行为的心理和认知改变的结果，与情绪无关。进一步的纵向研究应该验证这种可能性。对自杀行为的状态相关神经心理学特征的研究可能对检测急性自杀危机至关重要。
