SP05-48: Association between Cognitive Impairment and Suicidal Ideation in Patients with Major Depressive Disorder: A Prospective Study
Poster Presenter
Sadiq Ali Sayed
Medical Student
National Pirogov Memorial Medical University, Vinnytsya Ukraine
Objectives
To assess the association between suicidal ideation and cognitive impairment in patients with Major Depressive Disorder (MDD) and to better understand suicide risk and its management in adults with MDD.
Method
The prospective study was conducted at our medical institute from 11/04/2019-01/31/2020 on 114 patients. Suicidal ideation and cognitive function were assessed using standard scales. Data analysis was done by differential and statistical analysis. Differences were considered significant at p<0.05.
Results
Suicidal ideation and cognitive function were assessed using item 3 of the Hamilton Depression Rating Scale (HAM-D) and Brief Assessment of Cognition in Schizophrenia (BACS) respectively. Among the 114 patients, 66 (59.89%) were females whereas the rest were males. 97 patients were medicated (anti-depressants, anti-psychotics, mood stabilizers, anxiolytics, and/or anti-parkinsonian agents), while 17 patients were drug-free. 61 (53.51%) patients expressed suicidal ideation. Compared to patients with MDD without suicidal ideation, those with suicidal ideation demonstrated significantly lower BACS scores in the executive function domain (t=2.315, p<0.005). No differences were noted between the groups with respect to the other cognitive domains or composite scores. Spearman’s correlation coefficients were calculated to examine the relationship between the BACS scores, HAM-D score, and suicidal ideation (item 3 of the HAM-D). The composite score was modestly negatively correlated with the HAM-D score (?=-0.23, p<0.005). The executive function and motor speed domain scores were weakly negatively correlated with the HAM-D score (?=-0.19, p<0.01 and ?=-0.21, p<0.05, respectively). The executive function, motor speed, and composite scores were negatively correlated with suicidal ideation (item 3 of the HAM-D) (?=-0.20, p<0.005; ?=-0.21, p<0.05; and ?=-0.22, p<0.05, respectively). None of the other cognitive domain scores were associated with suicidal ideation. The HAM-D score was positively correlated with suicidal ideation (item 3 of the HAM-D) (? = 0.539, p<0.001).
Conclusion
Our findings suggest that the BACS executive function domain, motor speed domain, and composite scores are associated with suicidal ideation in patients with MDD and that the BACS is an efficient instrument for monitoring these characteristics. In addition, the present study demonstrated interesting relationships between the BACS motor speed domain and composite scores and suicidal ideation. In this study, motor speed was assessed with the Token Motor Task, which specifically evaluates psychomotor speed. Collectively, these findings suggest that dysfunction in specific cognitive domains (e.g., executive function and motor speed) and global neuropsychological impairment (BACS composite score) may be associated with suicidal ideation in patients with MDD who are currently in a depressive state. The current study indicated that patients with MDD with or without suicidal ideation could be distinguished by the presence of cognitive deficits in the executive function domain. Moreover, executive function, motor speed
function, and global neuropsychological impairment (BACS composite score) were each associated with the severity of suicidal ideation. Better understanding of suicidal ideation and its management in patients with cognitive impairment remain significant unmet public health needs. Urgency to address them derives from concern that CNS treatments for MDD may impact suicide risk. Regulatory guidances requiring assessment of emergent suicidal ideation and behavior (SI/SB) at every clinical trial visit need to be followed. Further studies on this topic are highly encouraged.
