Related Experiment Video
Updated: Jul 10, 2026
Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
Published on: April 26, 2024
Psychosocial and Biological Factors Associated with Non-Suicidal Self-Injury in Chinese Child and Adolescent
Chao Liu1, Xue-Yan Zhu1, Yan-Ni Shi1
1Department of Psychiatry, the Fourth People's Hospital of Nantong, Nantong, Jiangsu, 226000, People's Republic of China.
Insights
Non-suicidal self-injury (NSSI) is common in depressed youth and linked to emotional neglect, shame, anxiety, and cortisol levels. Integrated psychological and biological management is crucial for at-risk children.
Area of Science:
- Child and Adolescent Psychiatry
- Mental Health Research
- Psychosocial Factors in Illness
Background:
- Non-suicidal self-injury (NSSI) is a significant concern in pediatric mental health.
- Major Depressive Disorder (MDD) in children and adolescents is often comorbid with other psychiatric conditions.
- Understanding the factors associated with NSSI is critical for effective intervention.
Purpose of the Study:
- To determine the prevalence of NSSI among Chinese child and adolescent inpatients diagnosed with MDD.
- To identify psychosocial and biological factors associated with NSSI in this population.
- To inform integrated treatment strategies for high-risk youth.
Main Methods:
- A cross-sectional study of 177 inpatients (aged 10-16) diagnosed with MDD.
- Assessment of psychosocial factors using validated scales (CTQ, HAMD-24, HAMA, SS, MPAI).
- Measurement of biological markers including cortisol, thyroid hormones, and inflammatory markers.
Main Results:
- NSSI prevalence was 69.49%, with higher rates in females.
- NSSI group showed higher depression, anxiety, shame, mobile phone addiction scores, and elevated cortisol.
- Emotional neglect, depression severity, anxiety, shame, and cortisol levels were independently associated with NSSI.
Conclusions:
- NSSI is highly prevalent in child and adolescent MDD inpatients.
- Associated factors include emotional neglect, depression, anxiety, shame, and cortisol dysregulation.
- Integrated management of psychological and biological indicators is recommended for at-risk youth.
Object:
This study assessed the prevalence and associated psychosocial and biological factors of non-suicidal self-injury (NSSI) in Chinese child and adolescent inpatients diagnosed with major depressive disorder (MDD) by DSM-5 criteria.
Methods:
This cross-sectional study included 177 inpatients aged 10-16 years. Participants were assessed using the Childhood Trauma Questionnaire (CTQ), Hamilton Depression Scale (HAMD-24), Hamilton Anxiety Scale (HAMA), Shame Scale for Middle School Students (SS), and Mobile Phone Addiction Index (MPAI). Fasting blood levels of cortisol, thyroid hormones, and inflammatory markers were measured. Group comparisons (NSSI vs non-NSSI) used t-tests and chi-square tests, followed by binary logistic regression to identify independent associated factors of NSSI.
Results:
NSSI prevalence was 69.49%, with a higher proportion of females in the NSSI group. Compared to the non-NSSI patients, the NSSI group exhibited significantly higher scores on the HAMD-24, HAMA, shame, and MPAI scales, as well as higher cortisol and lower free triiodothyronine (FT3) levels. No significant differences were found in other biomarkers (Hypersensitive C-reactive protein, FT4, T3, T4, TSH, Adrenocorticotropic hormone). Regression analysis identified emotional neglect (OR = 1.223), depression severity (OR = 1.197), anxiety (OR = 1.186), shame (OR = 1.046), and cortisol (OR = 1.081) as significant factors associated with NSSI. Smartphone addiction and thyroid function-related indicators showed no significant association in the regression model.
Conclusion:
NSSI is highly prevalent among child and adolescent inpatients with MDD and is associated with emotional neglect, depressive and anxiety symptoms, shame-proneness, and dysregulated cortisol levels. Smartphone addiction and other biological markers (Hypersensitive C-reactive protein, FT4, T3, T4, TSH, and Adrenocorticotropic hormone) showed no independent association with NSSI in the final model. These findings highlight the importance of integrated management of psychological and biological indicators in high-risk children and adolescents.
Related Concept Videos
01:29Theoretical Approaches to Psychological Disorder
Biological approach
The biological approach posits that internal, organic factors are the primary causes of such disorders. This perspective emphasizes brain structure and function, genetic predispositions, and neurotransmitter imbalances. For example, schizophrenia has been associated with both genetic...
01:28Anorexia Nervosa
Symptoms and Physical Effects
Individuals with anorexia nervosa commonly exhibit extreme...
01:30Bulimia Nervosa
01:29Psychological and Sociocultural Causes of Schizophrenia
01:27Depressive Disorders: Etiology
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
01:28Conduct Disorder