ASR Suicide and Depression Studies Program, Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada.
ASR Suicide and Depression Studies Program, Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Neurosci Biobehav Rev. 2022 Jan;132:92-109. doi: 10.1016/j.neubiorev.2021.11.007. Epub 2021 Nov 11.
Growing evidence suggests cognitive deficits may represent neurocognitive markers with predictive utility in identifying those at risk for suicide. Characterizing these deficits may offer the opportunity to develop targeted interventions.
The aim of this systematic qualitative review is to provide a synthesis of the published data on neurocognition in suicide ideators and attempters in order to clarify which neurocognitive targets may be most relevant to address using cognitive-based psychotherapeutic strategies in patients at risk for suicide.
A total of 63 studies met criteria for inclusion. The most consistent findings were in depressed suicide attempters, where deficits in executive subdomains of inhibition, selective attention and decision-making, as well as in working memory, were identified. In contrast, no clear pattern of neurocognitive deficits emerged from studies in suicide ideators across diagnoses.
More studies are needed to clarify the role of cognitive deficits in specific subtypes of individuals at risk for suicide. The findings are discussed in the context of promising research on cognitive remediation and other psychological interventions.
越来越多的证据表明，认知缺陷可能是神经认知的标志物，具有预测自杀风险的效用。对这些缺陷进行描述可能为开发有针对性的干预措施提供机会。
本系统定性综述的目的是综合发表的数据，以了解自杀意念者和自杀未遂者的神经认知情况，以便明确哪些神经认知靶点可能与使用基于认知的心理治疗策略治疗有自杀风险的患者最相关。
共有 63 项研究符合纳入标准。最一致的发现是在抑郁自杀未遂者中，存在执行功能抑制、选择性注意和决策以及工作记忆等子领域的缺陷。相比之下，在各种诊断的自杀意念者中，研究并未明确显示出神经认知缺陷的模式。
需要更多的研究来阐明认知缺陷在特定自杀风险人群亚类中的作用。研究结果在关于认知矫正和其他心理干预的有前途的研究背景下进行了讨论。
