Catherine M McHugh1, Frank Iorfino1, Jacob J Crouse1, Ashleigh Tickell1, Alissa Nichles1, Natalia Zmicerevska1, Nicholas Ho1, Rico Lee2, Daniel F Hermens3, Elizabeth Scott4, Ian B Hickie1. 1. Youth Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia. 2. Brain and Mental Health Laboratory, Monash University, Melbourne, Australia. 3. Youth Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia; Thompson Institute, University of the Sunshine Coast, Birtinya, Australia. 4. Youth Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia; University of Notre Dame Australia, School of Medicine, Sydney, Australia.
Abstract
BACKGROUND: Neurocognitive impairment is recognised as a risk factor for suicidal behaviour in adults. The current study aims to determine whether neurocognitive deficits also predict ongoing or emergent suicidal behaviour in young people with affective disorders. METHODS: Participants were aged 12-30 years and presented to early intervention youth mental health clinics between 2008 and 2018. In addition to clinical assessment a standardised neurocognitive assessment was conducted at baseline. Clinical data was extracted from subsequent visits using a standardised proforma. RESULTS: Of the 635 participants who met inclusion criteria (mean age 19.6 years, 59% female, average follow up 476 days) 104 (16%) reported suicidal behaviour during care. In 5 of the 10 neurocognitive domains tested (cognitive flexibility, processing speed, working memory, verbal memory and visuospatial memory) those with suicidal behaviour during care were superior to clinical controls. Better general neurocognitive function remained a significant predictor (OR=1.94, 95% CI 1.29- 2.94) of suicidal behaviour in care after controlling for other risk factors. LIMITATIONS: The neurocognitive battery used was designed for use with affective and psychotic disorders and may not have detected some deficits more specific to suicidal behaviour. CONCLUSION: Contrary to expectations, better neurocognitive functioning predicts suicidal behaviour during care in young people with affective disorders. While other populations with suicidal behaviour, such as adults with affective disorders or young people with psychotic disorders, tend to experience neurocognitive deficits which may limit their capacity to engage in some interventions, this does not appear to be the case for young people with affective disorders.
BACKGROUND:Neurocognitive impairment is recognised as a risk factor for suicidal behaviour in adults. The current study aims to determine whether neurocognitive deficits also predict ongoing or emergent suicidal behaviour in young people with affective disorders. METHODS:Participants were aged 12-30 years and presented to early intervention youth mental health clinics between 2008 and 2018. In addition to clinical assessment a standardised neurocognitive assessment was conducted at baseline. Clinical data was extracted from subsequent visits using a standardised proforma. RESULTS: Of the 635 participants who met inclusion criteria (mean age 19.6 years, 59% female, average follow up 476 days) 104 (16%) reported suicidal behaviour during care. In 5 of the 10 neurocognitive domains tested (cognitive flexibility, processing speed, working memory, verbal memory and visuospatial memory) those with suicidal behaviour during care were superior to clinical controls. Better general neurocognitive function remained a significant predictor (OR=1.94, 95% CI 1.29- 2.94) of suicidal behaviour in care after controlling for other risk factors. LIMITATIONS: The neurocognitive battery used was designed for use with affective and psychotic disorders and may not have detected some deficits more specific to suicidal behaviour. CONCLUSION: Contrary to expectations, better neurocognitive functioning predicts suicidal behaviour during care in young people with affective disorders. While other populations with suicidal behaviour, such as adults with affective disorders or young people with psychotic disorders, tend to experience neurocognitive deficits which may limit their capacity to engage in some interventions, this does not appear to be the case for young people with affective disorders.
Authors: Catherine McHugh; Yun Ju Christine Song; Natalia Zmicerevska; Jacob Crouse; Alissa Nichles; Chloe Wilson; Nicholas Ho; Frank Iorfino; Adam Skinner; Elizabeth M Scott; Ian B Hickie Journal: BMJ Open Date: 2022-02-21 Impact factor: 2.692
Authors: José Enrique Layrón Folgado; Andrea Conchado Peiró; José H Marco; María Luisa Barrigón; Enrique Baca-García; Sandra Pérez Rodríguez Journal: Front Psychiatry Date: 2022-03-31 Impact factor: 4.157