TY - JOUR
T1 - Association between cognitive functioning, suicidal ideation and suicide attempts in major depressive disorder, bipolar disorder, schizophrenia and related disorders
T2 - A systematic review and meta-analysis
AU - Le, Gia Han
AU - Wong, Sabrina
AU - Haikazian, Sipan
AU - Johnson, Danica E
AU - Badulescu, Sebastian
AU - Kwan, Angela T H
AU - Gill, Hartej
AU - Di Vincenzo, Joshua D
AU - Rosenblat, Joshua D
AU - Mansur, Rodrigo
AU - Teopiz, Kayla M
AU - Rhee, Taeho Greg
AU - Ho, Roger
AU - Liao, Sonya
AU - Cao, Bing
AU - Schweinfurth-Keck, Nina
AU - Vinberg, Maj
AU - Grande, Iria
AU - Phan, Lee
AU - d'Andrea, Giacomo
AU - McIntyre, Roger S
N1 - Copyright © 2024. Published by Elsevier B.V.
PY - 2024/11/15
Y1 - 2024/11/15
N2 - INTRODUCTION: Treatable mental disorders, such as psychotic, major depressive disorder (MDD), and bipolar disorder (BD), contribute to a substantial portion of suicide risk, often accompanied by neurocognitive deficits. We report the association between cognitive function and suicidal ideation/suicide attempts (SI/SA) in individuals with schizoaffective disorder, BD, and MDD.METHODS: A systematic search was conducted on PubMed, Ovid and Scopus databases for primary studies published from inception to April 2024. Eligible articles that reported on the effect size of association between cognition and SI/SA were pooled using a random effects model.RESULTS: A total of 41 studies were included for analysis. There was a negative association between executive functioning and SI/SA in schizoaffective disorder (SA: Corr = -0·78, 95 % CI [-1·00, 0·98]; SI: Corr = -0·06, 95 % CI [-0·85, 0·82]) and MDD (SA: Corr = -0·227, 95 % CI [-0·419, -0·017]; SI: Corr = -0·14, 95 % CI [-0·33, 0·06]). Results were mixed for BD, with a significant positive association between SA and global executive functioning (Corr = 0·08, 95 % CI [0·01, 0·15]) and negative association with emotion inhibition. Mixed results were observed for processing speed, attention, and learning and memory, transdiagnostically.LIMITATIONS: There is heterogeneity across sample compositions and cognitive measures. We did not have detailed information on individuals with respect to demographics and comorbidities.CONCLUSIONS: We observed a transdiagnostic association between measures of cognitive functions and aspects of suicidality. The interplay of cognitive disturbances, particularly in reward-based functioning, may underlie suicidality in individuals with mental disorders. Disturbances in impulse control, planning, and working memory may contribute to self-injurious behavior and suicide.
AB - INTRODUCTION: Treatable mental disorders, such as psychotic, major depressive disorder (MDD), and bipolar disorder (BD), contribute to a substantial portion of suicide risk, often accompanied by neurocognitive deficits. We report the association between cognitive function and suicidal ideation/suicide attempts (SI/SA) in individuals with schizoaffective disorder, BD, and MDD.METHODS: A systematic search was conducted on PubMed, Ovid and Scopus databases for primary studies published from inception to April 2024. Eligible articles that reported on the effect size of association between cognition and SI/SA were pooled using a random effects model.RESULTS: A total of 41 studies were included for analysis. There was a negative association between executive functioning and SI/SA in schizoaffective disorder (SA: Corr = -0·78, 95 % CI [-1·00, 0·98]; SI: Corr = -0·06, 95 % CI [-0·85, 0·82]) and MDD (SA: Corr = -0·227, 95 % CI [-0·419, -0·017]; SI: Corr = -0·14, 95 % CI [-0·33, 0·06]). Results were mixed for BD, with a significant positive association between SA and global executive functioning (Corr = 0·08, 95 % CI [0·01, 0·15]) and negative association with emotion inhibition. Mixed results were observed for processing speed, attention, and learning and memory, transdiagnostically.LIMITATIONS: There is heterogeneity across sample compositions and cognitive measures. We did not have detailed information on individuals with respect to demographics and comorbidities.CONCLUSIONS: We observed a transdiagnostic association between measures of cognitive functions and aspects of suicidality. The interplay of cognitive disturbances, particularly in reward-based functioning, may underlie suicidality in individuals with mental disorders. Disturbances in impulse control, planning, and working memory may contribute to self-injurious behavior and suicide.
KW - Humans
KW - Bipolar Disorder/physiopathology
KW - Cognition
KW - Cognitive Dysfunction/physiopathology
KW - Depressive Disorder, Major/psychology
KW - Executive Function/physiology
KW - Psychotic Disorders/physiopathology
KW - Schizophrenia/physiopathology
KW - Suicidal Ideation
KW - Suicide, Attempted/statistics & numerical data
UR - http://www.scopus.com/inward/record.url?scp=85201892128&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2024.08.057
DO - 10.1016/j.jad.2024.08.057
M3 - Review
C2 - 39168166
SN - 0165-0327
VL - 365
SP - 381
EP - 399
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -