title: Is cognitive impairment associated with suicidality? A population-based study.
abstract: Suicide is one of the main causes of mortality in young people and in individuals with depression. The impact of impaired cognitive function on suicidal ideation is largely unknown. The aim of this study was to examine how cognitive functioning may influence suicidal thoughts, both in the general population and in a subgroup of individuals with depression. A total of 4583 participants (aged 18 years and older) were interviewed in a cross-sectional study of a representative sample of the non-institutionalized Spanish population. Cognitive functioning was evaluated using five cognitive tests. Participants were also asked to provide information about mental health symptoms and conditions through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Logistic regression analysis was performed overall and by age group. Lifetime prevalence of suicidal ideation was 3.7%, whereas prevalence of suicidal ideation in the previous 12 months was 0.9%. Depression was the strongest risk factor for suicidal ideation. Compared with people without suicidal ideation, people with suicidal ideas performed significantly worse on cognitive functioning after adjusting for age, years of education, gender, and the presence of depression. In the age-subgroup analyses, only the youngest group (18-49 years) showed a significant association between cognitive functioning and suicidal ideation. Worse cognitive functioning was also associated with more frequent suicidal ideas in those individuals with depression even when depression severity was taken into account. In conclusion, both cognitive functioning and diagnosis of depression are associated with higher risk of suicide in the Spanish general population, especially in young individuals.
authors.affiliation: Parc Sanitari Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, C/ Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Facultat de Medicina, Universitat de Barcelona, C/Casanova 143, 08036 Barcelona, Spain. Electronic address: e.lara@pssjd.org.
authors.forename: Elvira
authors.initials: E
authors.lastname: Lara
authors.affiliation: Parc Sanitari Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, C/ Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain. Electronic address: beatriz.olaya@pssjd.org.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Olaya
authors.affiliation: Parc Sanitari Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, C/ Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Facultat de Medicina, Universitat de Barcelona, C/Casanova 143, 08036 Barcelona, Spain. Electronic address: noe.garin@pssjd.org.
authors.forename: Noé
authors.initials: N
authors.lastname: Garin
authors.affiliation: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, C/ Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo 4, 28029 Madrid, Spain; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), C/ Diego de León 62, 28006 Madrid, Spain. Electronic address: joseluis.ayuso@uam.es.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Ayuso-Mateos
authors.affiliation: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, C/ Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Department of Psychiatry, Universidad Autónoma de Madrid, C/ Arzobispo Morcillo 4, 28029 Madrid, Spain; Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), C/ Diego de León 62, 28006 Madrid, Spain. Electronic address: marta.miret@uam.es.
authors.forename: Marta
authors.initials: M
authors.lastname: Miret
authors.affiliation: Parc Sanitari Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, C/ Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain. Electronic address: mvictoria.moneta@pssjd.org.
authors.forename: Victoria
authors.initials: V
authors.lastname: Moneta
authors.affiliation: Parc Sanitari Sant Joan de Déu, Dr Antoni Pujades, 42, Sant Boi de Llobregat, 08830 Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, C/ Monforte de Lemos 3-5, Pabellón 11, 28029 Madrid, Spain; Facultat de Medicina, Universitat de Barcelona, C/Casanova 143, 08036 Barcelona, Spain. Electronic address: jmharo@pssjd.org.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011581:Psychological Tests; D013030:Spain / Q000453:epidemiology; D059020:Suicidal Ideation; D055815:Young Adult
keywords: Cognitive functioning; Depression; Logistic regression models; Suicidal ideation