青年成人伴有自杀观念和行为的临床表现和决策问题的神经心理学研究

目的：研究伴有自杀观念与行为的青年成人是否存在神经认知方面的损害，探索其临床表现和神经心理学标记在临床中应用的潜在价值。方法从社区筛查入组321例青年成人，对其进行临床自杀评估、剑桥赌博任务（CGT）和信号暂停任务（SST）评估。对于伴或不伴自杀观念和行为者的临床表现和认知功能方面进行比较，寻找其相关的影响因素。结果在青年成人中自杀观念和行为相对来说比较普遍（广义：18.07%，狭义：7.79%）；在CGT中，伴与不伴自杀观念和行为者在理性决策中的差异有统计学意义（P＜0.05），在SST评估中差异均无统计学意义（均P＞0.05）。线性回归分析发现，年龄、性别、吸烟史以及CGT理性决策比例方面与自杀预测有关（P＜0.05）。结论伴有自杀观念和行为的青年成人在决策问题方面存在损害，从而导致一系列可能的自杀观念和行为。

Clinical manifestations and neuropsychological features of young adults with suicidality

Objective To investigate the clinical manifestations and neuropsychological features related to cognitive deficits in young adults with suicidality. Methods A sample of 321 young adults （18~29 y） was selected from community screening. Clinical suicide assessment and Cambridge Gamble and Stop- Signal tasks were used to evaluate the suicidality. Sui-cidality was defined as nonzero MINI scores （broad definition） and a past history of suicide attempt（s） （narrow definition）. Clinical features and cognitive performance were compared between subjects with suicidality and those without suicidality. Vari-ance/chi- square and linear regression were performed for statistical analysis. Results Suicidality was relatively common （broad definition： 18.07%; narrow definition：7.79%） in young people and was associated with impaired decision- making on the Cam-bridge Gamble task, there was significant difference in rate of rational decision- making between subjects with suicidality and those without （P〈0.05）. Linear regression demonstrated that decision- making performance had a higher value in predicting sui-cidality than demographic and clinical manifestations did （P〈0.05）. Conclusion Impaired decision- making exists in young adults with suicidality, which may predispose towards suicidal thoughts and attempts.