Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain.
Research Institute of Health Sciences (IUNICS), University of the Balearic Islands (UIB), Palma (Mallorca), Spain; Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitario Son Espases, Edificio S, Palma (Mallorca), Spain; Department of Psychology, University of the Balearic Islands (UIB), Palma (Mallorca), Spain.
Psychiatry Res. 2023 Jul;325:115235. doi: 10.1016/j.psychres.2023.115235. Epub 2023 May 7.
Impaired executive function (EF) is a key feature of patients with major depressive disorder (MDD) that several studies have linked to suicidal ideation and suicide attempts. This is the first longitudinal study to examine the association between impaired EF and suicide risk in adult patients with MDD. Longitudinal prospective study with 3 assessment points: baseline, 6 and 12 months. The Columbia-Suicide Severity Rating Scale (C-SSRS) was used to assess suicidality. The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess EF. The association between EF impairments and suicidality was analyzed using mixed-effects models. Out of 167 eligible outpatients, 104 were included in the study. Of these, 72 were re-evaluated at 6 months and 60 at 12 months, obtaining 225 complete observations of the EF. Impaired decision-making and risk-taking behavior were associated with suicidal ideation. Difficulty in impulse control was related to suicidal ideation and to greater severity of suicidal ideation. Impaired spatial planning and working memory was linked to suicide attempts. Our results add to previous literature that the association between EF impairments and suicidality is maintained over the long term, supporting it as a longitudinal risk factor and a possible neurocognitive marker of suicide in patients with MDD.
执行功能障碍是重度抑郁症 (MDD) 患者的一个主要特征，有几项研究将其与自杀意念和自杀企图联系起来。这是第一项纵向研究，旨在探讨 MDD 成年患者执行功能障碍与自杀风险之间的关联。
这是一项前瞻性纵向研究，共进行了 3 次评估：基线、6 个月和 12 个月。使用哥伦比亚自杀严重程度评定量表 (C-SSRS) 评估自杀倾向。使用剑桥神经心理学测试自动电池 (CANTAB) 评估执行功能。使用混合效应模型分析执行功能障碍与自杀倾向之间的关联。
在 167 名符合条件的门诊患者中，有 104 名纳入研究。其中，72 名患者在 6 个月时重新评估，60 名患者在 12 个月时重新评估，共获得 225 次完整的执行功能观察。
决策和冒险行为受损与自杀意念有关。冲动控制困难与自杀意念和自杀意念的严重程度有关。空间规划和工作记忆受损与自杀企图有关。
我们的研究结果增加了之前的文献，即执行功能障碍与自杀倾向之间的关联在长期内是保持不变的，支持了它作为一个纵向风险因素和 MDD 患者自杀的可能神经认知标志物。
