Serum Wnt Pathway Regulators in Adolescents with Suicidal Behavior Disorder and Nonsuicidal Self-injury Disorder: A...

The Wnt/β-catenin pathway plays a critical role in neuroplasticity and neurogenesis. The present study aimed to investigate whether circulating regulators of the Wnt/β-catenin pathway-Porcupine, Notum, and Dickkopf-1-differ in adolescents diagnosed with suicidal behavior disorder (SBD) and nonsuicidal self-injury disorder (NSSID) compared with control group.

This case-control study included adolescents aged 12 to 18 years: SBD (n = 41), NSSID (n = 40), and control group (n = 40). Diagnoses were established according to DSM-5 Section III criteria, and psychiatric comorbidities were assessed using the K-SADS-PL. Serum concentrations of Porcupine, Notum, and Dickkopf-1 were measured by ELISA. The Revised Child Anxiety and Depression Scale was used to evaluate the severity of psychiatric symptoms.

Serum Porcupine and Notum levels were significantly higher in both the SBD and NSSID groups than in control group, and these differences remained significant after adjusting for age and sex. In contrast, Dickkopf-1 levels did not differ between groups. When patients were reclassified according to psychotropic medication use, Porcupine and Notum levels remained elevated compared with control group in both medication users and non-users. Within the patient groups, no significant correlations were observed between biomarker levels and symptom scores.

Elevated serum Porcupine and Notum levels-modulators of the Wnt/β-catenin pathway-characterize adolescents with SBD and NSSID and are consistent with a potential shared biological substrate across self-harm phenotypes. Longitudinal, multicenter studies integrating central and peripheral measures are needed to clarify causality and clinical utility.