Characteristics And Correlates Of Cognitive Impairment In Adolescents With Depressive Disorder With Suicidal Ideation

Objective(s):With the increasing incidence of adolescent depressive disorder,adolescent depressive disorder is associated with a higher risk of suicide and more severe cognitive impairment than adult depressive disorder.Among the suicide risk factors of adolescent depressive disorder,suicidal ideation is very common,often stubborn and recurrent,and driven by suicidal ideation,the suicide risk of adolescent depressive disorder also rises sharply,even with adulthood or lifetime,which has seriously affected the growth and development of adolescents and social psychological function.Therefore,intervention and prevention for adolescent depressive disorder with suicidal ideation is particularly important.Based on this,the present study aims to compare factors associated with adolescent depressive disorder with and without suicidal ideation:Such as depression,anxiety severity,cognitive impairment,impulse,anhedonia and neuroelectrophysiological examination to explore the characteristics of cognitive impairment in adolescent depressive disorder with suicidal ideation.Methods:This cross-sectional study collected in June 2022 to January 2023 in our hospital psychiatric outpatient service and/or hospitalized adolescents with depressive disorders.A control group(HC group,n=21)matched with the enrolled patients in terms of sex,age,and education was recruited from the school during the same period.According to the Beck Scale for Suicide Ideation-Chinese Version(BSI-CV),the adolescent patients with depressive disorder were divided into two groups:adolescent MDD with suicidal ideation(SI group,n=40)and adolescent MDD without suicidal ideation(NSI group,n=36).Hamilton Depression Scale-24 item(HAMD-24),Hamilton Anxiety Scale-14(HAMA-14),Snaith-Hamilton Pleasure Scale(SHAPS),The Chinese Version of the Barratt Impulsivity Scale(BIS-II)were used to evaluate the severity of depression,anxiety,Anhedonia and impulse.The cognitive function of the three groups was evaluated by emotional Go/No-Go task and acquired ERP components(N2,P3).Statistical analysis was performed by SPSS26.0.Results:1.General demographic data and clinical information: SI group(n=40): 16(40%)males and 24(60%)females with a mean age of(14.64 ± 1.53)years;NSI group(n=36): 12(33.3%)males and 24(66.7%)females with a mean age of(15.29±1.59)years;HC group(n= 21): 13 cases(61.5%)in males and 8 cases(38.5%)in females,mean age(14.73 ±1.44)years.Comparison of the general demographic data of the three groups: there was no statistical difference between the three groups of subjects in terms of gender,age,and education(P > 0.05).The three groups of SI,NSI,and HC were matched in terms of gender,age,and education and were comparable;there was no significant difference in the disease duration between the SI and NSI groups(P >0.05).2.There were statistically significant differences in the total HAMD score,cognitive impairment factor,blocking factor,despair factor score and total HAMA-14 score,SHAPS and BIS-II score among the three groups of subjects(P < 0.05).Further two-by-two comparison revealed that the HAMD-24 total score,cognitive impairment factor score,HAMA-14 total score,SHAPS,and BIS-II scores were significantly higher in the SI and NSI groups than in the HC group(all P<0.05),and the HAMD-24 total score,cognitive impairment factor score,HAMA-14 total score,SHAPS,and BIS-II scores were higher in the SI group than in the NSI group(all P<0.05),and there was no statistical difference in the comparison between groups for the remaining dimensions(P>0.05).3.In the emotional Go/No Go task,in Go response time:SI group and NSI group had longer response time than HC group in all three emotional pictures,but no difference was found in response time between SI group and NSI group,and no difference was found in No Go correct rate between all three groups.4.In the emotional Go/No Go task,SI group,the NSI group under the emotional faces of amplitude is less than the HC group,and SI group No Go P3 amplitude is lower;Compared with the neutral and positive faces,SI group under the negative face P3 amplitude is lower;The amplitude and latency of Go N2/P3 and No Go N2 had no difference among the three groups.5.No-Go P3 amplitude was negatively correlated with HAMD-24 total score,cognitive impairment factor score,HAMA-14 total score and BIS-II(r=-0.325,-0.319,-0.391,-0.362,P <0.01).No-Go P3 amplitude was not significantly correlated with depression,anxiety severity,cognitive impairment,anhedonia and impulsivity under positive and neutral emotional faces.6.Logistic regression analysis showed that:HAMD-24(B 1.148,OR 1.554,P=0.015),cognitive impairment factor(B 0.834、OR 2.335、P=0.013)、HAMA-14(B1.465,OR 1.164,P<0.001)and amplitude of No-Go P3 under negative faces(B-1.052,OR 0.468,P=0.016)were risk factors of suicidal ideation in adolescent patients with depressive disorder.Conclusion(s):Adolescent depressive disorder patients with suicidal ideation had more serious anxiety,depression,anhedonia,impulsivity and cognitive impairment.They were significantly impaired in inhibition control under emotional interference,especially in negative emotions,and the impairment of inhibition control under negative emotions was closely related to anxiety,depression,cognitive impairment and impulsivity.Depression,anxiety,cognitive impairment and negative face inhibition control deficit were significant risk factors for suicidal ideation in adolescents with depression.