Suicidal risk and executive functions in major depressive disorder: a study protocol

Area of Science:

• Neuroscience
• Psychiatry
• Public Health

Background:

• Suicide is a major public health issue, with depression as a primary risk factor.
• Emerging research links suicidal behavior vulnerability to neurocognitive deficits, particularly in executive functions (EF), which are core symptoms of depression.

Purpose of the Study:

• To identify executive function (EF) alterations in patients experiencing a first depressive episode.
• To determine if these EF alterations serve as risk factors for suicidal ideation, attempts, and completed suicides.
• To inform the development of targeted suicide prevention strategies for individuals with first-episode depression.

Main Methods:

• A prospective longitudinal study design with two groups: first-episode depression with and without EF alterations.
• Four repeated measures over 24 months (0, 6, 12, 24 months) with a minimum sample size of 216 subjects.
• Assessment of socio-demographic, clinical (including depression severity, history, and suicidal behavior), and neuropsychological variables (EF and decision-making using CANTAB).

Main Results:

• The study aims to identify specific clinical and neuropsychological risk factors for suicidal behavior in first-episode depression.
• Results will highlight the association between executive function deficits and increased risk of suicidal ideation and behavior.
• The findings are expected to reveal impaired neurocognitive function as a potential endophenotype for suicidal behavior in depression.

Conclusions:

• Identification of clinical and neuropsychological risk factors will enhance suicide prevention in clinical practice for first-episode depression.
• Cognitive interventions targeting executive function deficits can be integrated into suicide prevention strategies.
• Impaired neurocognitive function, even early on, may serve as a valuable marker in research on suicidal behavior in depressive patients.