Leo Sher, M.D.

A research report, “Cognitive and emotional impairments underpinning suicidal activity in patients with mood disorders: An fMRI study” has been published in Acta Psychiatrica Scandinavica online ahead of print (1). The authors sought to determine the nature of neural responses to an emotional-cognitive task in patients with suicidal activity.

The Columbia Suicide Severity Rating Scale was employed to examine past month and lifetime suicidal activity: ideation, behavior, and total ideation or behavior (and the total of the two, provided a measure of suicidal activity as a whole). Neural responses to an Emotional Face-Word Stroop task were examined in 79 patients with mood disorders and 66 healthy controls. Among 79 patients, 43 were diagnosed with bipolar disorder and 36 with major depressive disorder. The authors identified regions of interest and assessed responses to incongruent stimuli (Happy face-‘Sad’ word; Sad face-‘Happy’ word).

In comparison to healthy controls, patients with mood disorders had differential activity during both incongruent conditions. Patients had significantly lower accuracy for incongruent face-word manipulations than healthy controls for both emotions (happy and sad). When examining for associations with suicidal activity within the patient group, those with higher Columbia Suicide Severity Rating Scale scores had decreased default mode network activity for Happy face-‘Sad’ word manipulation, and increased basal ganglia network activity for Sad face-‘Happy’ word manipulation. Increased levels of past-month suicidal ideation and behavior were associated with significant activity in brain regions involved in cognition-emotion interactions.

The authors concluded that suicidal activity in patients with mood disorders may be related to cognitive-emotional deficits. The authors also suggest that their findings lay a foundation for studying the neural correlates of suicidal activity and for a greater understanding of the processes involved.

Reference

1. Malhi GS, Das P, Outhred T, Gessler D, Mann JJ, Bryant R. Cognitive and emotional impairments underpinning suicidal activity in patients with mood disorders: An fMRI study. Acta Psychiatr Scand. 2019 Mar 13. doi: 10.1111/acps.13022. [Epub ahead of print]