Ruch Donna, Sheftall Arielle H, Heck Kendra, McBee-Strayer Sandra M, Tissue Jaclyn, Reynolds Brady, Ackerman John, Brent David A, Campo John V, Bridge Jeffrey A
The Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Suicide Prevention and Research, 700 Children's Drive, 3rd Floor FOB, Columbus, OH, 43205, USA.
The Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Suicide Prevention and Research, 700 Children's Drive, 3rd Floor FOB, Columbus, OH, 43205, USA; The Ohio State University Wexner Medical Center, College of Medicine - Department of Psychiatry and Behavioral Health 370 W. 9th Avenue, Columbus, OH, 43210, USA.
J Psychiatr Res. 2020 Dec;131:119-126. doi: 10.1016/j.jpsychires.2020.08.032. Epub 2020 Sep 2.
Neurocognitive deficits have been associated with suicidal behavior in adults with major depressive disorder (MDD), but it is unclear if similar impairments are linked to youth suicidal behavior. This study compared neurocognitive functioning in suicidal and non-suicidal youth with a lifetime history of MDD and explored whether neurocognitive functioning predicted future suicide attempts. Neurocognition was examined using the Cambridge Neuropsychological Test Automated Battery (CANTAB) and Iowa Gambling Task (IGT) in 309 youths ages 12-15 (117 suicide attempters; 132 suicidal ideators; 60 never-suicidal). Prospective analyses included 284 youths (41 youth with a future attempt; 243 without a future attempt). Multivariate analysis of variance (MANOVA) yielded a significant group-by-sex interaction effect [Wilks' Λ = 0.901, F (16, 560) = 1.87, p = .021] for the primary neurocognitive outcomes, guiding the decision to stratify the sample by sex. Female suicide attempters and ideators were slower to respond correctly to both positive and negative emotion words than never-suicidal controls on tests of affective bias. Male suicide attempters and ideators made significantly more total and between errors than never-suicidal subjects. Exploratory analyses found that total commission errors on the Affective Go/No-Go (AGN) test significantly predicted future suicide attempts in females, and that higher strategy scores on Spatial Working Memory (SWM) tests predicted future male attempts. Study findings identified sex-specific neurocognitive deficits that differentiate suicidal and non-suicidal youth with histories of MDD. Extended longitudinal studies are needed to elucidate the temporal association between neurocognitive impairments and suicidal behavior and frame targets for early preventive interventions.
神经认知缺陷与重度抑郁症（MDD）成年患者的自杀行为有关，但目前尚不清楚类似的损害是否与青少年自杀行为有关。本研究比较了有自杀行为和无自杀行为的青少年（均有MDD病史）的神经认知功能，并探讨了神经认知功能是否能预测未来的自杀企图。使用剑桥神经心理测试自动成套系统（CANTAB）和爱荷华赌博任务（IGT）对309名12至15岁的青少年进行了神经认知测试（117名有自杀企图者；132名有自杀意念者；60名无自杀史者）。前瞻性分析纳入了284名青少年（41名有未来自杀企图者；243名无未来自杀企图者）。多变量方差分析（MANOVA）得出，在主要神经认知结果方面，存在显著的性别×组间交互效应[威尔克斯λ=0.901，F（16,560）=1.87，p=0.021]，这为按性别对样本进行分层的决策提供了指导。在情感偏差测试中，女性自杀企图者和有自杀意念者对积极和消极情绪词汇的正确反应速度均慢于无自杀史的对照组。男性自杀企图者和有自杀意念者在总错误数和组间错误数上均显著多于无自杀史的受试者。探索性分析发现，情感Go/No-Go（AGN）测试中的总执行错误显著预测了女性未来的自杀企图，而空间工作记忆（SWM）测试中较高的策略得分预测了男性未来的自杀企图。研究结果确定了特定性别的神经认知缺陷，这些缺陷区分了有MDD病史的自杀青少年和无自杀行为的青少年。需要进行长期的纵向研究，以阐明神经认知障碍与自杀行为之间的时间关联，并为早期预防干预确定目标。
