McGirr, A., Alda, M., Séguin, M., Cabot, S., Lesage, A., & Turecki, G. (2009). Familial aggregation of suicide explained by cluster B traits: A three-group family ...
Cognitive endophenotypes of suicide: A study in first-degree relatives of suicide completers Alexandra Hoehne, Yang Ding, Stephane Richard-Devantoy, Martin Lepage, Gustavo Turecki, Fabrice Jollant McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, Québec, Canada
Background
Results
Tasks and Paradigms
Heritability of Suicide
Decision-Making- Iowa Gambling Task
Cognitive inhibition Paradigm:
• Estimated heritability of 50% (McGirr et al., 2009) • Transmission of risk appears to follow vulnerability traits more than co-morbid disorders like depression
• Suicide attempters (SA) show cognitive deficits including impaired decision-making and cognitive inhibition (Jollant et al., 2005; McGirr et al., 2012; RichardDevantoy et al., 2013)
Rela=ve of Healthy Control
Rela=ve of Depressed
Rela=ve of Suicide Completer
20 18
RHC, RPC > RSC
RHC > RPC, RSC
16
IGT Net Score
Cognitive deficits in suicide attempters
Iowa Gambling Task Mean Net Scores per Trial Blocks
• Classical task of cognitive inhibition • 3 Conditions: Denomination, Lecture, Interference
RHC > RPC, RSC
14 12 10 8 6 4 2 0 -‐2 -‐4 -‐6 -‐8
-‐10 -‐12
Potential suicide endophenotype • OBJECTIVE: To investigate cognitive deficits found in SA in first-degree relatives of suicide completers. These could constitute a cognitive endophenotype of suicide.
The STROOP color test
Trial 1-‐20
Trial 21-‐40
Trial 41-‐60
Trial 61-‐80 Trial 81-‐100
IGT 20 card =ers
Freedman Test RHC: Freedman = 24.1, p < 0.000 RPC: Freedman = 12.7, p < 0.01 RHC: Freedman = 7.3, p < 0.1
Decision-Making Paradigm:
The Iowa Gambling Task
*
Methods Participants • 17 first-degree relatives of suicide completers (RSC) were compared to 18 first-degree relatives of individuals with Major Depressive Disorder (RMDD) and 19 firstdegree relatives of healthy controls (RHC)
Discussion
• Inclusion criteria: Males and females aged from 20 to 65 years old. • Non-inclusion criteria: Criteria for all participants included personal history of suicidal behavior, substance dependence in the last year, major comorbid psychiatric disorders. Also, RMDD and RHC with any familial history of suicidal behavior were not included.
Kruskal Wallis = 6.3, p < 0.04
• RSC exhibit decision-making and cognitive inhibition impairments similar to those previously observed in SA.
Cognitive Inhibition- STROOP
• Deficits in evaluative and cognitive inhibitory processes appear to be transmissible suicide vulnerability traits.
Clinical Assessment • • • •
p < 0.03
• Decision-making and cognitive inhibition deficits may constitute a cognitive suicide endophenotype. • Findings need to be reproduced using a larger sample. • Future research in RSC would increase our understanding of suicide heritability and potentially improve our ability to predict suicidal behavior.
Socio-demographic criteria Current and past Axis I disorders (SCID I) Depression (Hamilton Rating Scale for Depression) Personality traits/disorders (SCID II)
Neuropsychological Assessment • Decision-Making (Iowa Gambling Task- IGT) • Cognitive inhibition (Stroop Color test, Trail-Making test and Hayling Sentence Completion test) • Verbal fluency (FAS verbal fluency test) • Working memory (subscale of WISC-IV) • Verbal IQ measure (National Adult Reading Test)
References Kruskal Wallis = 5.7, p < 0.06 Mann-Whitney RSC > RPC, p > 0.03
• McGirr, A., Alda, M., Séguin, M., Cabot, S., Lesage, A., & Turecki, G. (2009). Familial aggregation of suicide explained by cluster B traits: A three-group family study of suicide controlling for major depressive disorder. American Journal of Psychiatry, 166(10), 1124-1134. • Jollant, F., Bellivier, F., Leboyer, M., Astruc, B., Torres, S., Verdier, R., et al. (2005). Impaired decision making in suicide attempters. American Journal of Psychiatry, 162(2), 304-310. • McGirr, A., Jollant, F., Turecki, G. (2013). Neurocognitive alterations in first degree relatives of suicide completers. Journal of Affective Disorders, 145(2), 264-269. • Richard-Devantoy, S., Olie, E., Guillaumec, S., Bechara, A., Courtet, P., Jollant, F. (2013). Distinct valuebased decision-making and cognitive control in suicide attempters: Toward a dual neurocognitive model. Journal of Affective Disorders, 151(3), 1120-1124.
Acknowledgements • Funding for this study was provided by the American Foundation for Suicide Prevention • M.Sc. funding: Faculty of Medicine Internal Studentship- McGill University
