“Hard to say, hard to understand, hard to live”: possible associations between neurologic language impairments and suicide risk

Costanza, Alessandra ORCID logoORCID: https://orcid.org/0000-0001-6387-6462, Amerio, Andrea ORCID logoORCID: https://orcid.org/0000-0002-3439-340X, Aguglia, Andrea ORCID logoORCID: https://orcid.org/0000-0002-2003-2101, Magnani, Luca, Serafini, Gianluca ORCID logoORCID: https://orcid.org/0000-0002-6631-856X, Amore, Mario, Merli, Roberto, Ambrosetti, Julia, Bondolfi, Guido ORCID logoORCID: https://orcid.org/0000-0002-4352-5531, Marzano, Lisa ORCID logoORCID: https://orcid.org/0000-0001-9735-3512 and Berardelli, Isabella ORCID logoORCID: https://orcid.org/0000-0003-0602-871X (2021) “Hard to say, hard to understand, hard to live”: possible associations between neurologic language impairments and suicide risk. Brain Sciences, 11 (12) , e1594. pp. 1-13. ISSN 2076-3425 [Article] (doi:10.3390/brainsci11121594)

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In clinical practice, patients with language impairments often exhibit suicidal ideation (SI) and suicidal behavior (SB, covering the entire range from suicide attempts, SA, to completed suicides). However, only few studies exist regarding this subject. We conducted a mini-review on the possible associations between neurologic language impairment (on the motor, comprehension, and semantic sides) and SI/SB. Based on the literature review, we hypothesized that language impairments exacerbate psychiatric comorbidities, which, in turn, aggravate language impairments. Patients trapped in this vicious cycle can develop SI/SB. The so-called “affective prosody” provides some relevant insights concerning the interaction between the different language levels and the world of emotions. This hypothesis is illustrated in a clinical case that we reported, consisting of the case of a 74-year old woman who was admitted to a psychiatric emergency department (ED) after a failed SA. Having suffered an ischemic stroke two years earlier, she suffered from incomplete Broca’s aphasia and dysprosody. She also presented with generalized anxiety and depressive symptoms. We observed that her language impairments were both aggravated by the exacerbations of her anxiety and depressive symptoms. In this patient, who had deficits on the motor side, these exacerbations were triggered by her inability to express herself, her emotional status, and suffering. SI was fluctuant, and—one year after the SA—she completed suicide. Further studies are needed to ascertain possible reciprocal and interacting associations between language impairments, psychiatric comorbidities, and SI/SB. They could enable clinicians to better understand their patient’s specific suffering, as brought on by language impairment, and contribute to the refining of suicide risk detection in this sub-group of affected patients.

Item Type: Article
Additional Information: This article belongs to the Special Issue Expecting the Unexpected: Novel, Paradoxical and Surprising Findings in Neurobiology of Language
Keywords (uncontrolled): suicide, suicidal behavior, suicidal ideation, suicide attempt, language, aphasia, verbal fluency, dysprosody, emotional speech, semantic dementia
Research Areas: A. > School of Science and Technology > Psychology
Item ID: 34243
Notes on copyright: Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Depositing User: Jisc Publications Router
Date Deposited: 06 Dec 2021 10:41
Last Modified: 07 Jan 2022 09:07
URI: https://eprints.mdx.ac.uk/id/eprint/34243

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