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Purpose: Previous studies have observed cognitive inflexibility in depressed patients may be associated with suicide risk, gaps exist in knowledge of cognitive flexibility in different gradations of suicidal ideation (SI). This study examined whether cognitive flexibility differed between depressed patients with passive and active SI. Methods: Depressed patients currently experiencing a major depressive episode with either passive (n = 35) or active (n = 18) SI completed assessments of cognitive flexibility using perseverative errors of Wisconsin Card Sorting Test (WCST-PE). Multivariate logistic regression was used to estimate the odds ratio (OR) for cognitive flexibility (WCST-PE) between active and passive SI patients after adjustment for gender, age, diagnostic composition, and depression severity. Results: Patients with active SI are associated with greater cognitive inflexibility compared to passive SI after adjusting for other covariates (OR: 1.26, 95% confidence interval: 1.01-1.58, p=0.04). Conclusions: This study found that patients with active SI are associated with greater cognitive inflexibility than those with passive SI, which can provide insight into improved prevention.

Difference in Cognitive Flexibility between Passive and Active Suicidal Ideation in Patients with Depression