Neuropsychological function and suicidal behavior: attention control, memory and executive dysfunction in suicide attempt

Psychol Med. 2013 Mar;43(3):539-51. doi: 10.1017/S0033291712001419. Epub 2012 Jul 10.


Background: Executive dysfunction, distinct from other cognitive deficits in depression, has been associated with suicidal behavior. However, this dysfunction is not found consistently across samples.

Method: Medication-free subjects with DSM-IV major depressive episode (major depressive disorder and bipolar type I disorder) and a past history of suicidal behavior (n = 72) were compared to medication-free depressed subjects with no history of suicidal behavior (n = 80) and healthy volunteers (n = 56) on a battery of tests assessing neuropsychological functions typically affected by depression (motor and psychomotor speed, attention, memory) and executive functions reportedly impaired in suicide attempters (abstract/contingent learning, working memory, language fluency, impulse control).

Results: All of the depressed subjects performed worse than healthy volunteers on motor, psychomotor and language fluency tasks. Past suicide attempters, in turn, performed worse than depressed non-attempters on attention and memory/working memory tasks [a computerized Stroop task, the Buschke Selective Reminding Task (SRT), the Benton Visual Retention Test (VRT) and an N-back task] but not on other executive function measures, including a task associated with ventral prefrontal function (Object Alternation). Deficits were not accounted for by current suicidal ideation or the lethality of past attempts. A small subsample of those using a violent method in their most lethal attempt showed a pattern of poor executive performance.

Conclusions: Deficits in specific components of attention control, memory and working memory were associated with suicidal behavior in a sample where non-violent attempt predominated. Broader executive dysfunction in depression may be associated with specific forms of suicidal behavior, rather than suicidal behavior per se.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attention / physiology*
  • Bipolar Disorder / physiopathology
  • Bipolar Disorder / psychology
  • Cognition Disorders / physiopathology*
  • Cognition Disorders / psychology
  • Depressive Disorder, Major / physiopathology*
  • Depressive Disorder, Major / psychology
  • Executive Function / physiology*
  • Female
  • Humans
  • Male
  • Memory / physiology*
  • Models, Statistical
  • Neuropsychological Tests / statistics & numerical data
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychomotor Performance / physiology
  • Risk Factors
  • Suicidal Ideation
  • Suicide, Attempted / psychology*
  • Violence / psychology
  • Young Adult