Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China.
Department of Pharmacy, Peking University First Hospital, Beijing, China.
Suicide Life Threat Behav. 2020 Dec;50(6):1181-1188. doi: 10.1111/sltb.12689. Epub 2020 Sep 19.
To determine whether suicidal ideation or suicide attempts are linked to poor neurocognitive function among individuals with first-episode schizophrenia (FES).
We performed a cross-sectional study on 159 Chinese inpatients (M = 27.1 years; 52.2% females) with minimal-treated FES and collected their suicidal history through interviews and medical records. Neurocognitive performance, psychopathology, and depressive symptoms were assessed using the MATRICS Consensus Cognitive Battery, the Positive and Negative Syndrome Scale, and the Calgary Depression Scale for Schizophrenia, respectively.
Approximately 1/10 FES inpatients had any suicide attempts, and more than 1/4 reported lifetime suicidal ideation. Inpatients with a suicide attempt or suicidal ideation scored significantly worse in the overall seven neurocognitive domains compared with those without past suicidal ideation or a suicide attempt. Linear regression suggested that suicide attempts were mainly associated with lower scores in working memory and speed of processing, after adjusting for education levels. The associations remained robust after further controlling for psychopathological and depressive symptoms.
First-episode schizophrenia patients with suicide attempts had more severely impaired neurocognitive performances in specific domains. Fundamental neurocognitive dysfunctions should be assessed, detected, and treated after their suicide risk assessments.
探讨首发精神分裂症患者自杀意念或自杀未遂与神经认知功能障碍的关系。
我们对 159 名接受最低限度治疗的首发精神分裂症住院患者（M=27.1 岁，52.2%为女性）进行了横断面研究，通过访谈和病历收集了他们的自杀史。使用 MATRICS 共识认知电池、阳性和阴性症状量表和 Calgary 精神分裂症抑郁量表分别评估神经认知表现、精神病理学和抑郁症状。
约 1/10 的首发精神分裂症住院患者有过自杀尝试，超过 1/4 的患者有过自杀意念。与无自杀意念或自杀尝试的患者相比，有自杀尝试或自杀意念的患者在七个总体神经认知领域的得分明显更低。线性回归表明，在校正教育程度后，自杀尝试主要与工作记忆和处理速度的较低分数相关。在进一步控制精神病理学和抑郁症状后，关联仍然稳健。
有自杀尝试的首发精神分裂症患者在特定领域的神经认知表现严重受损。在评估自杀风险后，应评估、发现和治疗基本的神经认知功能障碍。
