01 Sep Risky Decision Making May Run in Families Prone To Suicide
MedicalResearch.com Interview with:
Fabrice Jollant, MD, PhD
McGill University, Department of Psychiatry
& Douglas Mental Health University Institute
McGill Group for Suicide Studies
Montréal (Québec), Canada
Medical Research: What is the background for this study? What are the main findings?
Dr. Jollant: Suicide takes almost 1 million lives each year worldwide. Improving suicide prevention necessitates improving our understanding of the mechanisms leading to these complex acts. We know that while many people who died from suicide had experienced negative life events (divorce, job loss, grief), most people who experience these events will not commit suicide, not even think about suicide. Similarly, while more than 90% of suicide completers had suffered a major mental disorders (mainly depression and substance abuse) and treating these mental disorders can reduce suicide rates, 90% of patients will never die from suicide. Thus, research focuses now on the specific factors that make some individuals more vulnerable. We previously found that individuals who attempted suicide are more likely to make risky choices at a gambling task than patients who went through depression but never attempted suicide. They tend to choose the options that yield more gains immediately but are long-term disadvantageous. People who choose this way are also more likely to have problems in their interpersonal relationships, a classic trigger of suicidal crisis.
Medical Research: What are the main findings?
Dr. Jollant: This study continues our previous series of investigations. Here, we assessed decision-making in close biological relatives of suicide completers. We know that suicide is heritable and can run within some families. So, we were interested in knowing if risky decision-making could be one factor transmitted within families of suicide completers. We recruited healthy individuals who had lost a close biological relative from suicide, but never attempted suicide themselves. We found that these persons also tend to choose the riskiest options. However, we could not find some other cognitive deficits previously found in suicide attempters, e.g. deficient cognitive control. These normal cognitions may therefore counterbalance their deficits in decision-making and maybe protect them against suicide.
Medical Research: What should clinicians and patients take away from your report?
Dr. Jollant: These findings confirm the fact that risky decision-making may be one important risk factor of suicide when individuals get depressed. These deficits may be traits, i.e. they are found even when people are fine, they tend to persist in the long run and seem to be heritable. It also highlights the concept of vulnerability to suicide at the cognitive level, the idea that some individuals may remain at risk of triggering a suicidal crisis when things go wrong in their lives.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Jollant: We plan to assess how to improve decision-making in patients. Preliminary results from a research conducted at the Douglas Institute in Montreal (Canada) with Dr Marcelo Berlim showed that the stimulation with a small current of the orbitofrontal cortex, a brain region located just above the eyes, leads to improved decision-making performance in healthy individuals. We would like to know if similar findings could be obtained in patients. Other therapeutic perspectives to investigate are some medications and psychotherapies. But we are just at the beginning of the story. In the end, we will also have to test if improving decision-making reduces the suicidal risk in long-term.
Citation:
J Psychiatr Res. 2015 Sep;68:192-7. doi: 10.1016/j.jpsychires.2015.07.004. Epub 2015 Jul 3.
Hoehne A1, Richard-Devantoy S2, Ding Y1, Turecki G1, Jollant F3.
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MedicalResearch.com Interview with:, & Fabrice Jollant, MD, PhD (2015). Risky Decision Making May Run in Families Prone To Suicide
Last Updated on September 1, 2015 by Marie Benz MD FAAD