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已发表论文
中国儿童和青少年重度抑郁障碍住院患者非自杀性自伤相关的心理社会和生物学因素
Authors Liu C, Zhu XY, Shi YN , Wang PJ, Jiang WH, Zhou J, Qiu JC, Chen PF, Ding JC, Yan Q, Ding YQ
Received 26 September 2025
Accepted for publication 16 January 2026
Published 24 January 2026 Volume 2026:22 570371
DOI https://doi.org/10.2147/NDT.S570371
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Roger Pinder
Chao Liu,* Xue-Yan Zhu,* Yan-Ni Shi,* Pei-Juan Wang, Wei-Hong Jiang, Jia Zhou, Jian-Cheng Qiu, Peng-Fei Chen, Jing-Cheng Ding, Qi Yan, Ya-Qin Ding
Department of Psychiatry, the Fourth People’s Hospital of Nantong, Nantong, Jiangsu, 226000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Qi Yan, Department of Psychiatry, the Fourth People’s Hospital of Nantong, No. 37 Cheng Gang Road, Nantong, Jiangsu, 226000, People’s Republic of China, Email yanqi85605761@163.com Ya-Qin Ding, Department of Psychiatry, the Fourth People’s Hospital of Nantong, No. 37 Cheng Gang Road, Nantong, Jiangsu, 226000, People’s Republic of China, Email nt4ydyq@126.com
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.
Keywords: non-suicidal self-injury, major depressive disorder, child and adolescent inpatients, cortisol, emotional neglect
Department of Psychiatry, the Fourth People’s Hospital of Nantong, Nantong, Jiangsu, 226000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Qi Yan, Department of Psychiatry, the Fourth People’s Hospital of Nantong, No. 37 Cheng Gang Road, Nantong, Jiangsu, 226000, People’s Republic of China, Email yanqi85605761@163.com Ya-Qin Ding, Department of Psychiatry, the Fourth People’s Hospital of Nantong, No. 37 Cheng Gang Road, Nantong, Jiangsu, 226000, People’s Republic of China, Email nt4ydyq@126.com
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.
Keywords: non-suicidal self-injury, major depressive disorder, child and adolescent inpatients, cortisol, emotional neglect