Scientific article
Case report
Open access

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

Published inBrain sciences, vol. 11, no. 12, 1594
Publication date2021-11-30
First online date2021-11-30

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 presentation, 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.

  • Anxiety
  • Aphasia
  • Depression
  • Dysprosody
  • Emotional speech
  • Emotions
  • Language
  • Prosody
  • Semantic dementia
  • Suicidal behavior
  • Suicidal ideation
  • Suicide
  • Suicide attempt
  • Verbal fluency
Citation (ISO format)
COSTANZA, Alessandra et al. “Hard to say, hard to understand, hard to live”: possible associations between neurologic language impairments and suicide risk. In: Brain sciences, 2021, vol. 11, n° 12, p. 1594. doi: 10.3390/brainsci11121594
Main files (1)
Article (Published version)
ISSN of the journal2076-3425

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