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Cited by 372Suicide and Self-Harm StudiesNeural and Behavioral Psychology StudiesTreatment of Major Depression

Neuropsychological dysfunction in depressed suicide attempters

Keilp, John G., Sackeim, Harold A., Brodsky, Beth S., Oquendo, Maria A., Malone, Kevin M., Mann, J. John·2001·American Journal of Psychiatry
DOI 10.1176/appi.ajp.158.5.735
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Abstract

OBJECTIVE: Neuropsychological deficits in the context of psychiatric disease may be associated with suicide risk. In this study, neuropsychological performance was compared among depressed patients with at least one prior suicide attempt of high lethality, depressed patients with low-lethality prior attempts, depressed patients with no prior suicide attempts, and nonpatients. METHOD: Fifty unmedicated patients in a major depressive episode (21 with no history of suicide attempts and 14 and 15 patients with previous attempts of low and high lethality, respectively) and 22 nonpatients were assessed. Groups were comparable in age, education, occupational level, and estimated premorbid intelligence. The neuropsychological battery produced scores within five composite domains: general intellectual functioning (current), motor functioning, attention, memory, and executive functioning. RESULTS: Patients whose prior suicide attempts were of high lethality performed significantly worse than all groups on tests of executive functioning and were the only group to perform significantly worse than nonpatients on tests of general intellectual functioning, attention, and memory. A discriminant function analysis revealed two prominent dimensions in the data: one that discriminated high-lethality suicide attempters from all other groups (primarily associated with performance on tests of executive functioning) and another that discriminated all depressed patient groups from nonpatients (associated with performance on measures of attention and memory). For the patients with high-lethality prior suicide attempts, deficits did not appear to reflect diffuse brain damage from past attempts, since the results of tests commonly affected by diffuse injury were not selectively impaired. CONCLUSIONS: Neuropsychological deficits in depressed patients with high-lethality prior suicide attempts suggest impairment of executive functioning beyond that typically found in major depression. This more extensive neuropsychological impairment in the context of depression may be a risk factor for severe suicide attempts.

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  • Keilp and colleagues found that adult suicide attempters performed poorly on frontal executive tasks relative to controls, similar to King and colleagues' observation in older adult attempters.

    “Keilp and colleagues found that adult suicide attempters performed poorly on frontal executive tasks relative to controls (33), a similar observation to one made by King and colleagues in older adult attempters (34).”

    From Suicide in older adults (2011) · cites this paper as [33]

  • Impaired cognitive control is the most consistent deficit found in suicide attempters.

    “These learning deficits scale with attempt lethality and are partially explained by impaired cognitive control (34), the most consistent deficit found in suicide attempters (17, 22, 24).”

    From A brain-centric model of suicidal behavior (2020) · cites this paper as [24]

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Authors
Keilp, J. G., Sackeim, H. A., Brodsky, B. S., Oquendo, M. A., Malone, K. M., & Mann, J. J.
Affiliations
New York State Psychiatric Institute (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2001-05-01
Volume
158
Issue
5
Pages
735-741
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.158.5.735
OpenAlex
W2097765762
Cited by
372
References
56
Citations by year
2026: 7 · 2025: 13 · 2024: 13 · 2023: 11 · 2022: 19 · 2021: 20 · 2020: 17 · 2019: 16 · 2018: 37 · 2017: 15 · 2016: 21 · 2015: 21 · 2014: 25 · 2013: 20 · 2012: 18
FWCI
5.33
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (MH46745)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
neuropsychological deficits, major depressive disorder, suicide attempts, executive function, attention, memory, intellectual functioning, motor function, suicide risk, discriminant function analysis
MeSH terms
Adult, Aged, Depressive Disorder, Female, Humans, Male, Middle Aged, Motor Skills, Neuropsychological Tests, Personality Inventory, Psychiatric Status Rating Scales, Suicide, Attempted, Wechsler Scales, Multivariate Analysis

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