Citation

Szanto K, Dombrovski AY, Sahakian BJ, Mulsant BH, Houck PR, Reynolds CF, Clark L. Am. J. Geriatr. Psychiatry 2012; 20(3): 257-265.

Affiliation

From the Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pennsylvania (KS, PRH, AYD, CFR); Department of Experimental Psychology, University of Cambridge, UK (LC), MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, UK (BJS, LC); Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK (BJS); Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Canada (BHM).

Copyright

(Copyright © 2012, American Association for Geriatric Psychiatry, Publisher Elsevier Publishing)

DOI

10.1097/JGP.0b013e31820eea0c

PMID

22354116

PMCID

PMC3286029

Abstract

OBJECTIVES:: Lack of feeling connected and poor social problem solving have been described in suicide attempters. However, cognitive substrates of this apparent social impairment in suicide attempters remain unknown. One possible deficit, the inability to recognize others' complex emotional states has been observed not only in disorders characterized by prominent social deficits (autism-spectrum disorders and frontotemporal dementia) but also in depression and normal aging. This study assessed the relationship between social emotion recognition, problem solving, social functioning, and attempted suicide in late-life depression. DESIGN, PARTICIPANTS, MEASUREMENTS:: There were 90 participants: 24 older depressed suicide attempters, 38 nonsuicidal depressed elders, and 28 comparison subjects with no psychiatric history. We compared performance on the Reading the Mind in the Eyes test and measures of social networks, social support, social problem solving, and chronic interpersonal difficulties in these three groups. RESULTS:: Suicide attempters committed significantly more errors in social emotion recognition and showed poorer global cognitive performance than elders with no psychiatric history. Attempters had restricted social networks: they were less likely to talk to their children, had fewer close friends, and did not engage in volunteer activities, compared to nonsuicidal depressed elders and those with no psychiatric history. They also reported a pattern of struggle against others and hostility in relationships, felt a lack of social support, perceived social problems as impossible to resolve, and displayed a careless/impulsive approach to problems. CONCLUSIONS:: Suicide attempts in depressed elders were associated with poor social problem solving, constricted social networks, and disruptive interpersonal relationships. Impaired social emotion recognition in the suicide attempter group was related.

Language: en