Executive functions and impulsivity in suicide attempter adolescents with major depressive disorder

ABSTRACT OBJECTIVE: The aim of this study was to examine the relationship between executive functions and suicidality in terms of impulsivity and depression severity. METHODS: Depressed adolescents who have made a suicide attempt in the last year (n？=？32), depressed adolescents without a suicide attempt (n？=？30), and healthy controls (n？=？30) participated in the study in Dokuz Eylul University Faculty of Medicine, Department of Child and Adolescent Psychiatry. Clinical diagnoses were made according to the DSM-IV by applying Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL). Data were collected by using a sociodemographic data form, the Beck Depression Inventory (BDI), Barratt Impulsiveness Scale, and the Children’s Depression Rating Scale – Revised (CDRS-R). To evaluate all participants’ intelligence scores, the Wechsler Intelligence Scale for Children (WISC-R) was applied for adolescents aged under 16 years, and the Wechsler Adult Intelligence Scale (WAIS) was applied to adolescents aged 16–18 years. To determine the performance-based executive functions, Wisconsin Card Sorting Test and Stroop Test were applied to all participants. RESULTS: In this study, the participants who had made a suicide attempt displayed lower performance in the Stroop Test, especially in part 1 and part 4 compared with the controls (p？=？.04 and p？=？.011). Depressive patients also exhibited lower performance in the Stroop Test in part 3 compared with the controls (p？=？.049). Impulsivity was found more severe in depressive patients compared with controls (p？<？.001). There were no statistically significant differences between depressive patients with or without suicide attempt in terms of depression severity. CONCLUSION: Executive dysfunction appears to be associated with suicidal behaviour in adolescents with the major depressive disorder. This findings need to be replicated with a larger sample size in the future