Universidad del País Vasco/Euskal Herriko Unibertsitatea, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain; Networking Center for Biomedical Research in Mental Health (CIBERSAM), Spain.
Universidad del País Vasco/Euskal Herriko Unibertsitatea, Spain; Department of Psychiatry, Araba University Hospital, Bioaraba Research Institute, Vitoria-Gasteiz, Spain; Networking Center for Biomedical Research in Mental Health (CIBERSAM), Spain.
J Affect Disord. 2021 Jan 1;278:488-496. doi: 10.1016/j.jad.2020.09.044. Epub 2020 Sep 13.
Suicide is a major health concern worldwide, thus, identifying risk factors would enable a more comprehensive understanding and prevention of this behaviour. Neuropsychological alterations could lead to difficulties in interpreting and managing life events resulting in a higher risk of suicide.
A systematic literature search from 2000 to 2020 was performed in Medline (Pubmed), Web of Science, SciELO Citation Index, PsycInfo, PsycArticles and Cochrane Library databases regarding studies comparing cognition of attempters versus non-attempters that share same psychiatric diagnosis.
1.885 patients diagnosed with an Affective Disorder (n = 1512) and Schizophrenia/ Schizoaffective Disorder (n = 373) were included. In general comparison, attention was found to be clearly dysfunctional. Regarding diagnosis, patients with Schizophrenia and previous history of suicidal behaviour showed a poorer performance in executive function. Patients with current symptoms of an Affective Disorder and a previous history of suicidal attempt had poorer performance in attention and executive function. Similarly, euthymic affective patients with history of suicidal behaviour had worse decision-making, attention and executive function performance compared to euthymic non-attempters.
The number of papers included in this review is limited to the few studies using non-attempter clinically-matched control group and therefore results regarding diagnosis, symptomatology and time of the attempt are modest and contradictory.
Patients who have attempted suicide have a poorer neuropsychological functioning than non-attempters with a similar psychiatric disorder in attention and executive function. These alterations increase vulnerability for suicide.
自杀是全球范围内的一个主要健康问题，因此，确定风险因素将使人们更全面地了解和预防这种行为。神经心理学改变可能导致在解释和处理生活事件方面出现困难，从而增加自杀的风险。
从 2000 年至 2020 年，我们在 Medline（PubMed）、Web of Science、SciELO 引文索引、PsycInfo、PsycArticles 和 Cochrane Library 数据库中进行了系统的文献检索，以查找比较有相同精神科诊断的尝试自杀者和非尝试自杀者认知的研究。
共纳入 1885 名被诊断为情感障碍（n=1512）和精神分裂症/分裂情感障碍（n=373）的患者。总体比较发现，注意力明显存在功能障碍。就诊断而言，有精神分裂症和以前有自杀行为史的患者在执行功能方面表现较差。目前有情感障碍症状且以前有自杀尝试史的患者在注意力和执行功能方面表现较差。同样，有自杀行为史的心境稳定的情感障碍患者在决策、注意力和执行功能方面的表现明显差于心境稳定的非尝试者。
本综述中包含的论文数量有限，仅限于少数使用非尝试者临床匹配对照组的研究，因此关于诊断、症状和尝试时间的结果是适度和矛盾的。
与具有相似精神科疾病的非尝试者相比，尝试过自杀的患者在注意力和执行功能方面的神经心理学功能较差。这些改变增加了自杀的脆弱性。
