A recent study published in the Journal of Affective Disorders examines the relationship between cognitive functioning, suicidal ideation, suicide attempts across major psychiatric disorders, including major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia. Conducted by a team at the University Health Network in Toronto, the study collected data from 41 studies involving over 23,000 individuals and aimed to quantify the association between specific cognitive impairments and the occurrence of suicidal ideation and suicide attempts in individuals diagnosed with MDD, BD, schizophrenia, and related disorders.
The group identified a significant negative correlation between global executive functioning and the history of suicide attempts in individuals with schizophrenia and schizoaffective disorder. This suggests that individuals with greater impairments in executive functioning, such as planning, decision-making, and impulse control, are more likely to have attempted suicide. Interestingly, the study found a contrasting pattern in individuals with bipolar disorder, where a significant positive correlation was observed between global executive functioning and the history of suicide attempts. The group’s data indicates that the relationship between cognitive functioning and suicidal behavior can vary significantly depending on the specific psychiatric disorder.
In addition to executive functioning, the study also explored the role of cognitive inhibition, particularly in the context of emotional regulation, in relation to suicidal behavior. The findings suggest that deficits in cognitive inhibition, or an individual’s ability to suppress inappropriate or unwanted thoughts and impulses, are strongly associated with suicide attempts in individuals with bipolar disorder. These deficits may predispose individuals to impulsive actions, including self-harm, particularly in the presence of intense emotional distress.
The study also examined the relationship between attention and processing speed and suicidal behavior, though the results were mixed. In some cases, significant deficits in these cognitive domains were observed among individuals with a history of suicide attempts, particularly in those with schizophrenia. However, the strength and consistency of these associations varied across studies, indicating that further research is needed.
Collectively, the study’s results underscore the critical need for clinicians to assess cognitive functioning as part of the overall risk assessment for suicidality in patients with major psychiatric disorders. By identifying cognitive deficits early, clinicians may be able to intervene more effectively, potentially reducing the risk of suicidal ideation and behavior. The researchers suggest that interventions aimed at improving cognitive functions, such as cognitive-behavioral therapy or pharmacotherapy targeting cognitive deficits, could play a crucial role in reducing suicidality in these populations.
Reference:
Han Le G et al Journal of Affective Disorders 2024;365:381-399. Abstract