Background: Suicide has profound effects on individuals, families, and societies globally, underscoring the urgent need for effective early detection and prevention strategies. This systematic review aims to investigate the use of event-related potentials (ERPs) as a tool for identifying and monitoring suicide risk.
Methods: A comprehensive literature search was conducted, resulting in the inclusion of 23 articles that met the eligibility criteria. The review synthesized findings related to various ERP components associated with suicide risk.
Results: The analysis revealed that individuals with a history of suicide risk exhibited significantly reduced P3 amplitudes in response to novel stimuli during the go/no-go paradigm compared to healthy controls [standardized mean difference (SMD) = -0.53, 95% confidence interval (CI) = [-0.96; -0.10]]. Additionally, altered P3 responses to positive feedback on rewards indicated impairments in those at risk (SMD = -1.12, 95% CI = [-1.74; -0.49]). Variability in other ERP components was also highlighted, with several moderators, such as sample characteristics and methodological design, influencing ERP components.
Conclusion: The findings suggest that specific ERP components, particularly the P3, may serve as valuable indicators for assessing suicide risk. The review emphasizes the need for future research to utilize larger, more homogeneous samples and advanced analytical techniques to enhance detection accuracy. The application of ERPs is posited as a promising avenue for improving understanding of the neurocognitive mechanisms associated with suicide risk and enhancing prevention efforts.
Keywords: P3; cognitive processing; electroencephalography (EEG); event-related potentials (ERPs); neural indicators; suicide risk.
© The Author(s) 2025. Published by Oxford University Press on behalf of West China School of Medicine/West China Hospital (WCSM/WCH) of Sichuan University.