Cognitive flexibility in inpatient children and adolescents with a history of suicide attempts.

An increase in suicide rates during adolescence has made it the second leading cause of death for this age group. While potential deficits in cognitive flexibility have been thought to contribute to suicidality, this factor has been evaluated in only a few studies among this age group. The current study sought to evaluate cognitive flexibility in 100 psychiatric inpatient children and adolescents (age X=14.39, SD=2.53), with (n=26) and without (n=74) a history of suicide attempts, using the Wisconsin Card Sorting Test (WCST). Results showed no differences between the groups in WCST scores. However, in a small sub-sample with mood disorders only, those with a history of a suicide attempt performed better than those without such history. These findings are contrary to our hypothesis that those who attempted suicide have worse cognitive flexibility, though consistent with earlier data in adults. Further research is needed to shed light on these findings.

Social skills, executive functioning and social engagement.

The study explored hypothesized mediation of social interaction skills between executive functions and social engagement among adolescents diagnosed with schizophrenia. Participants (N = 92; 62% boys; age = 16.8) were assessed four weeks after hospitalization using previously validated scales. A regression mediation analysis followed by Structural Equation Modeling (SEM; with bootstrap analysis) supported the hypothesis. Executive functions were significantly associated with communication skills, which in turn was associated with social engagement (indirect effect = 0.29; standardized). These findings highlight the importance of understanding the heterogeneity of executive functions among adolescent patients with schizophrenia, and the subsequent association with their social skills and engagement.

Cognitive traits in inpatient adolescents with and without prior suicide attempts and non-suicidal self-injury.

OBJECTIVE: Establishing a psychiatric diagnosis and assessing suicidal tendencies is often a challenging task particularly in the early stages of an illness. Cognitive impairments characterize different psychiatric entities, but there is no known specific cognitive deficit profile that could help the clinician in achieving the diagnostic task. This study's aim was to establish a cognitive profile and test its ability to differentiate psychiatric inpatient subgroups, in terms of suicidal risk and diagnosis. The sample constituted of 76 consecutive admissions to the psychiatric adolescent day-care unit, who were admitted for any diagnosis. Assessment included full psychiatric interview and cognitive evaluation, using the COGNISTAT test. RESULTS: Of the 76 participants, 58% reported having suicidal ideation and 29% reported a prior attempted suicide. Subjects who had a prior suicide attempt had better orientation and attention scores in the COGNISTAT. Other cognitive domains did not differentiate between groups or diagnoses. CONCLUSION: These preliminary results suggest a significant association between specific cognitive characteristics and suicidal behavior in adolescents. Those cognitive characteristics might prove clinically useful in the assessment of suicide risk. Further study is needed to establish this association and generalize the conclusion to different populations.