Altered explicit recognition of facial disgust associated with predisposition to suicidal behavior but not depression

Background: Suicidal acts result from a complex interplay between vulnerability factors, such as reduced social and cognitive abilities, social stressors. To our knowledge nothing is known about the explicit recognition of others' facial emotions, a major component of social interactions, in patients at long-term risk for suicide.

Methods: Thirty-five non-depressed patients with a history of a serious suicide attempt and mood disorders were compared with 31 patients with a history of mood disorders but no personal history of suicidal acts, and with 37 healthy controls with no personal history of mood disorders or suicide attempts. The explicit recognition of six facial emotions (anger, disgust, fear, sadness, happiness, and neutral) was assessed.

Results: Suicide attempters made significantly more errors in the explicit recognition of disgust, relative to the other groups, with no differences between the control groups or for the other emotions examined. Semantic verbal fluency and verbal working memory performances were also reduced in suicide attempters relative to the other two groups but could not explain the facial recognition deficits.

Limitations: Our results need replication with a larger sample size. Most patients were medicated.

Conclusions: Explicit recognition of disgust appears to be specifically altered in relation to vulnerability to suicide but not to depression. Reduced ability to recognize some social emotions may impair the patient's capacity to adequately interact with his own social environment, potentially increasing the risk of interpersonal conflict, negative emotions and suicidal crisis. Improving cognitive and social skills may be a target for future individual suicide prevention.