Analysis of risk factors of non-suicidal self-harm behavior in adolescents with depression

Background: Adolescents are a high-risk group for non-suicidal self-injury (NSSI), which seriously affects their physical and mental health. This study aimed to explore the risk factors for depressive adolescents with NSSI. Methods: A total of 153 adolescents with depression were divided into the NSSI group (n=65) and nonNSSI group (n=88) according to the criteria stipulated by Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The Beck scale for suicidal ideation (BSS), adolescent self-rating life events checklist (ASLEC), family adaptability and cohesion evaluation scale II-Chinese version (FACES IICV), childhood trauma questionnaire short form (CTQ SF), and multidimensional scale of perceived social support (MSPSS) were applied to evaluate suicidal ideation, frequency and intensity of stressful life events, family functions, childhood trauma, and perceived support, respectively. We applied two-dimensional logistic regression to identify risk factors for NSSI. Results: Female gender ratio, suicidal ideation, and attempted suicide were significantly higher in the NSSI group than in the non-NSSI group (all P<0.05). Scores of interpersonal relationships in ASLEC, emotional abuse, and emotional neglect in the CTQ-SF were significantly higher in the NSSI group than those in the non-NSSI group (all P<0.001). The scores of family cohesion (P=0.001) and family adaptability (P=0.01) were significantly lower in the NSSI group than in the non-NSSI group. The MSPSS was used to assess support from the family, and the index was significantly lower in the NSSI group (P<0.001). After adjusting for age and gender, BSS score, interpersonal relationship score, emotional abuse score, and emotional neglect score were identified as independent risk factors for NSSI. Conclusions: The rate of NSSI in adolescents with depression is high. Higher scores of BSS, interpersonal relationship, emotional abuse, and neglect were independently associated with NSSI.