Neuropsychological performance, past-month active suicidal ideation, and lifetime suicide attempt history in individuals with psychosis: A cross-sectional study.

BACKGROUND

Individuals with psychosis have elevated suicide risk and neuropsychological dysfunction. Prior research on neurocognition and suicidality in psychosis is mixed, with better cognition linked to both greater and lower history of suicide ideation (SI) and suicide attempts (SA). The current study examined associations between neuropsychological performance, demographics, psychiatric symptoms, past month SI, and lifetime SA history in individuals with psychosis.

METHOD: 235 adults with schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features completed clinical interviews, neuropsychological assessment, and symptom measures (positive and negative symptoms; depressive symptoms). Participants were grouped by past month active SI (SI+; n = 110) versus passive/no SI (SI-; n = 125) and lifetime actual SA history (SA+; n = 152) versus no SA (SA-; n = 83). Among SA + participants, we examined lifetime aborted attempts, interrupted attempts, preparatory behaviors, and attempt lethality. False Discovery Rate correction was used for multiple comparisons.

STUDY

RESULTS

SI + individuals reported more severe depressive and positive symptoms; only depressive symptoms uniquely predicted SI. SA + individuals were significantly older and had worse working memory and processing speed than SA-individuals, but only age uniquely predicted SA history. Those with aborted attempt history demonstrated better premorbid intellectual functioning and working memory; only working memory remained significant in the multivariable model. After FDR correction, there were no significant predictors of interrupted attempts, preparatory behavior, or attempt lethality.

CONCLUSIONS

Current SI may be more closely associated with symptoms, whereas better working memory may be associated with aborting a suicide attempt.