Peng Bo, Li Jinmeng, Liu Haitao, Fang Han, Zhao Weitan, Chen Guanjie, Xiu Meihong, Zhang Yingli
Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, China.
Shenzhen Mental Health Center, Shenzhen, China.
Front Pediatr. 2022 Jun 3;10:822046. doi: 10.3389/fped.2022.822046. eCollection 2022.
Non-suicidal self-injury (NSSI) is a serious public health problem widely present among young adults and adolescents. While finding risk factors associated with NSSI among young patients with major depressive disorder (MDD) is challenging, the current study aims to measure childhood adversity and serum cortisol levels and elucidate their relationship in MDD patients with NSSI.
In this cross-sectional study, 126 young patients with MDD (aged 16 to 35 years) were recruited. The depressive symptoms were assessed by the Beck Depression Inventory (BDI-II), and the childhood adversity was evaluated by the Chinese version of the Childhood Trauma Questionnaire (CTQ) scale. Serum cortisol levels were determined by the kits in patients.
Relative to MDD patients without NSSI, MDD patients with NSSI had a higher CTQ total score and its four subscores. Moreover, the cortisol levels in patients with MDD/NSSI were significantly decreased than in MDD patients without NSSI. For patients with MDD/NSSI, there is a negative association between cortisol levels and emotional neglect, but not for MDD patients without NSSI. Further regression analysis showed that low cortisol levels, BDI-II, and emotional neglect were risk factors for NSSI in young patients with MDD.
Our findings suggest that young MDD patients with NSSI experience more childhood adversity and have lower cortisol levels. Also, lower cortisol levels were associated with childhood adversity but not with depressive symptoms. Further, lower cortisol levels, depressive symptoms, and emotional neglect were risk factors for NSSI in young patients with MDD.
非自杀性自伤（NSSI）是一个严重的公共卫生问题，广泛存在于青年人和青少年中。虽然在患有重度抑郁症（MDD）的年轻患者中寻找与NSSI相关的风险因素具有挑战性，但本研究旨在测量童年逆境和血清皮质醇水平，并阐明它们在患有NSSI的MDD患者中的关系。
在这项横断面研究中，招募了126名患有MDD的年轻患者（年龄在16至35岁之间）。通过贝克抑郁量表（BDI-II）评估抑郁症状，通过中文版儿童创伤问卷（CTQ）量表评估童年逆境。使用试剂盒测定患者的血清皮质醇水平。
与没有NSSI的MDD患者相比，患有NSSI的MDD患者的CTQ总分及其四个子分数更高。此外，MDD/NSSI患者的皮质醇水平明显低于没有NSSI的MDD患者。对于MDD/NSSI患者，皮质醇水平与情感忽视之间存在负相关，但对于没有NSSI的MDD患者则不存在。进一步的回归分析表明，低皮质醇水平、BDI-II和情感忽视是年轻MDD患者发生NSSI的风险因素。
我们的研究结果表明，患有NSSI的年轻MDD患者经历了更多的童年逆境，且皮质醇水平较低。此外，较低的皮质醇水平与童年逆境有关，但与抑郁症状无关。此外，较低的皮质醇水平、抑郁症状和情感忽视是年轻MDD患者发生NSSI的风险因素。
