Niu Shan, Yin Xiaoxiao, Pan Bing, Chen Haotian, Dai Chunxiao, Tong Chunnan, Chen Fang, Feng Xiuqin
Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Department of Psychiatry, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Neuropsychiatr Dis Treat. 2024 Jan 4;20:1-17. doi: 10.2147/NDT.S443454. eCollection 2024.
Non-suicidal self-injury (NSSI) and depression often co-occur among adolescents with more severe clinical symptoms. This study examined the network structures of NSSI and depressive symptoms in adolescents.
Participants were recruited in the psychiatric outpatient clinics of three tertiary hospitals between April 10 and July 10, 2023. All participants been already found with self-injury behaviors in outpatient when enrolled. NSSI diagnostic criteria and Patient Health Questionnaire-9 (PHQ-9) were utilized to collect NSSI and depressive symptoms separately. We performed a network analysis to visualize the correlation between each symptom and to identify core and bridging symptoms in comorbidities.
A total of 248 patients were enrolled in the study, with a mean age of 15.48 (SD = 1.62). Based on the PHQ-9 scores and grades, our results showed that the incidence of depression in adolescents with non-suicidal self-injury behavior was relatively high (N=235, 94.76%), with the majority having severe depression. The network analysis revealed that nodes D-6 "feeling bad, failing or letting yourself or your family down", D-1 "little interest or pleasure" and D-4 "feeling tired" were the most vital and most central symptoms. The most crucial bridging symptom is the node NSSI-8 "frequent thinking about self-injury", which connects the NSSI to the depression comorbid network.
This study offers a significant symptom-level conceptualization of the association between NSSI and depressive symptoms in a clinical sample of adolescents, which not only enhances our understanding of the comorbid but also identifies potential treatment targets to prevent and treat comorbidity between adolescent NSSI and depression.
非自杀性自伤（NSSI）和抑郁症在临床症状更严重的青少年中常常同时出现。本研究探讨了青少年中NSSI和抑郁症状的网络结构。
2023年4月10日至7月10日期间，在三家三级医院的精神科门诊招募参与者。所有参与者在入组时门诊已发现有自伤行为。采用NSSI诊断标准和患者健康问卷-9（PHQ-9）分别收集NSSI和抑郁症状。我们进行了网络分析，以可视化每种症状之间的相关性，并确定共病中的核心症状和桥梁症状。
本研究共纳入248例患者，平均年龄15.48岁（标准差=1.62）。根据PHQ-9评分和等级，结果显示有非自杀性自伤行为的青少年抑郁症发病率较高（N=235，94.76%），大多数为重度抑郁症。网络分析显示，节点D-6“感觉糟糕、失败或让自己或家人失望”、D-1“兴趣或乐趣缺乏”和D-4“感到疲倦”是最重要、最核心的症状。最关键的桥梁症状是节点NSSI-8“频繁思考自伤”，它将NSSI与抑郁共病网络连接起来。
本研究为青少年临床样本中NSSI与抑郁症状之间的关联提供了重要的症状水平概念化，这不仅增进了我们对共病的理解，还确定了预防和治疗青少年NSSI与抑郁症共病的潜在治疗靶点。
