Executive functioning in men with schizophrenia and substance use disorders: influence of lifetime suicide attempts
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BACKGROUND: Lifetime suicide attempts in patients with comorbidity between psychotic disorders and Substance Use Disorder (SUD), known as dual diagnosis, was associated with a worse clinical and cognitive state, poor prognosis and premature death. However, to date no previous study has examined the cognitive performance of these patients considering as independent the presence or absence of lifetime suicide attempts. METHODS: We explore executive functioning differences between suicide attempters and non-attempters in dual schizophrenia (DS) patients and the possible related factors for both executive performance and current suicide risk. Fifty DS male patients in remission of SUD and clinically stables, 24 with and 26 without lifetime suicide attempts, were evaluated. We considered Z scores for all neuropsychological tests and a composite summary score for both premorbid IQ and executive functioning. RESULTS: DS patients showed low performance in set-shifting, planning and problem solving tasks. Those with suicide attempts presented lower composite summary scores, together with worse problem solving skills and decision-making, compared with non-attempters. However, after controlling for alcohol dependence, only differences in decision-making remained. Executive functioning was related to the premorbid intelligence quotient, and several clinical variables (duration, severity, months of abstinence and relapses of SUD, global functioning and negative symptoms). A relationship between current suicide risk, and first-degree relatives with SUD, insight and positive symptoms was also found. CONCLUSIONS: Our results suggest that problem solving and, especially, decision-making tasks might be sensitive to cognitive impairment of DS patients related to presence of lifetime suicide attempts. The assessment of these executive functions and cognitive remediation therapy when necessary could be beneficial for the effectiveness of treatment in patients with DS. However, further research is needed to expand our findings and overcome some limitations of this study.
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Clinical and cognitive insight are associated with heightened suicidality.
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Why clinical neuropsychology matters in schizophrenia care
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Does Alcohol Influence Cognitive Functions in Patients with Schizophrenia?
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Mood computational mechanisms underlying increased risk behavior in adolescent suicidal patientsPreprint
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- Authors
- Adan, A., Capella, M. D. M., Prat, G., Forero, D. A., López-Vera, S., & Navarro, J. F.
- Affiliations
- Universitat de Barcelona (ES)
- Universidad Antonio Nariño (CO)
- Universidad de Málaga (ES)
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-01-18
- Volume
- 12
- Issue
- 1
- Pages
- e0169943
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC5242526
- OpenAlex
- W2574982328
- Cited by
- 50
- References
- 54
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 2 · 2023: 3 · 2022: 7 · 2021: 8 · 2020: 9 · 2019: 4 · 2018: 6 · 2017: 1
- FWCI
- 4.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (publishedVersion, other-oa)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Spanish Ministry of Economy and Competitiveness (PSI2012-32669 and PSI2015-65026 (MINECO/FEDER/UE))
- Universitat de Barcelona (APIF-2011)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- executive function, schizophrenia, substance use disorders, dual diagnosis, lifetime suicide attempts, suicide risk, problem solving, decision-making, set-shifting, premorbid intelligence, cognitive impairment, negative symptoms, alcoholism, cognitive remediation
- MeSH terms
- Adult, Alcoholism, Decision Making, Humans, Male, Neuropsychological Tests, Problem Solving, Schizophrenia, Schizophrenic Psychology, Suicide, Attempted, Comorbidity, Substance-Related Disorders, Executive Function
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