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Neurocognitive markers of passive suicidal ideation in late-life depression

Published online by Cambridge University Press:  29 October 2020

Joshua T. Jordan
Affiliation:
Department of Psychology, Dominican University of California, San Rafael, CA, USA Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
Christina F. Chick
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
Camarin E. Rolle
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
Nathan Hantke
Affiliation:
Mental Health and Clinical Neuroscience Division, VA Portland Health Care System, Portland, OR, USA Department of Neurology, Oregon Health and Science University, Portland, OR, USA
Christine E. Gould
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Geriatric Research, Education, and Clinical Centers (GRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
Julie Lutz
Affiliation:
Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
Makoto Kawai
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
Isabelle Cotto
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
Rosy Karna
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
Sophia Pirog
Affiliation:
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Michelle Berk
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
Keith Sudheimer
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
Ruth O’Hara
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
Sherry A. Beaudreau
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Sierra Pacific Mental Illness Research, Education and Clinical Centers (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
Corresponding

Abstract

Objectives:

(1) To delineate whether cognitive flexibility and inhibitory ability are neurocognitive markers of passive suicidal ideation (PSI), an early stage of suicide risk in depression and (2) to determine whether PSI is associated with volumetric differences in regions of the prefrontal cortex (PFC) in middle-aged and older adults with depression.

Design:

Cross-sectional study.

Setting:

University medical school.

Participants:

Forty community-dwelling middle-aged and older adults with depression from a larger study of depression and anxiety (NIMH R01 MH091342-05 PI: O’Hara).

Measurements:

Psychiatric measures were assessed for the presence of a DSM-5 depressive disorder and PSI. A neurocognitive battery assessed cognitive flexibility, inhibitory ability, as well as other neurocognitive domains.

Results:

The PSI group (n = 18) performed significantly worse on cognitive flexibility and inhibitory ability, but not on other neurocognitive tasks, compared to the group without PSI (n = 22). The group with PSI had larger left mid-frontal gyri (MFG) than the no-PSI group. There was no association between cognitive flexibility/inhibitory ability and left MFG volume.

Conclusions:

Findings implicate a neurocognitive signature of PSI: poorer cognitive flexibility and poor inhibitory ability not better accounted for by other domains of cognitive dysfunction and not associated with volumetric differences in the left MFG. This suggests that there are two specific but independent risk factors of PSI in middle- and older-aged adults.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2020

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Footnotes

#

Co-senior authors.

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