Abstract
Background
Death ideation(DI) is a complex thought tangled with negative emotions and poor judgements, which may involve dysfunctional brain function. A prominent symptom of ADHD is executive dysfunction, while MDD is related to cognitive decline during depression. Inflammatory processes have been linked to MDD, although their effects on ADHD and depressive symptoms remain unclear. Also, appetite hormone dysregulation is related to excutive dysfunction and emotional dysregulation.
Aims & Objectives
To determine whether inflammation, appetite hormone, and cognition all had the same or different effects on DI in two distinct disorders.
Method
Adolescents aged 12–17 with ADHD or major depression with death ideations(DI) were included. Control group adolescents were healthy(HC) without DSM-5 diagnoses or DI history. DI was based on the DI item of the BDI-Y. All participants completed the demographic and the Beck Depression Inventory for Youth(BDI-Y) survey, blood draw for pro-inflammatory cytokines and appetite hormones, and the Wisconsin Card Sorting Test(WCST) for cognitive function assessment. Statistical analysis was performed using the analysis of variance(F-test) for continuous variables and Pearson’s test for categorical variables. Kolmogorov-Smirnov tests were used to transform levels of proinflammatory cytokines and appetite hormones into logs. Generalized linear models(GLMs) were used to compare levels of appetite hormones and proinflammatory cytokines and executive function between groups.
Results
Total 54 adolescents with DI, including 20 ADHD, 34 MDD, and 59 HC. The association between DI and biomarkers and cognitive performance tests indicates that elevated levels of CRP(B = 0.19, p = 0.042) and an increased percentage of non-perseverative errors(B = 0.02, p = 0.012) are correlated with more DI. The analysis found that individuals with DI+ADHD exhibited more deficits in executive function, while DI+MDD demonstrated more increased concentrations of leptin, CRP, and TNF-α relative to the control group.
Discussion & Conclusions
Inflammation and cognitive deficits may contribute to DI pathogenesis. Inflammation may have a larger role in DI development in the DI+MDD group, while cognitive abnormalities may be more important in DI+ADHD. More research is needed to understand the causes behind these disparities to design more tailored solutions and meet each subgroup's distinct requirements.
