Associations of non-suicidal self-injury with childhood maltreatment and inflammatory cytokines in adolescents with major depressive disorder.

BACKGROUND

Major depressive disorder (MDD) is a prevalent mental health problem among adolescents, with non-suicidal self-injury (NSSI) behaviors representing a prominent symptomatic manifestation. There is growing evidence that NSSI is associated with childhood maltreatment (CM) and inflammatory cytokines. However, these associations have not been sufficiently researched in adolescents with MDD. This study aimed to investigate such associations in depressed adolescents.

METHODS

The Centre for Epidemiological Studies Depression Scale (CES-D) and the Childhood Trauma Questionnaire (CTQ) were used to assess depressive symptoms and CM, respectively. Additionally, plasma levels of interleukin (IL)-1β, IL-6, IL-10, IL-17 A, and tumor necrosis factor-α (TNF-α) were measured.

RESULTS

The detection rate of NSSI in adolescents with MDD was 63.8%. Patients with NSSI had higher scores of CES-D and CTQ as well as inflammatory cytokines levels (especially IL-1β) than non-NSSI patients (all p < 0.05). Further analysis demonstrated that lower age (OR = 0.724, 95% CI = 0.55 ∼ 0.952), elevated IL-1β levels (OR = 6.256, 95% CI = 1.861 ∼ 21.032), higher total CES-D score (OR = 1.033, 95% CI = 0.999 ∼ 1.068), and a higher emotional abuse score (OR = 1.117, 95% CI = 1.021 ∼ 1.222) were independent risk factors for NSSI. Finally, the receiver operating characteristic (ROC) analysis indicated that the combination of IL-1β, emotional abuse, age, and total CES-D score was a good predictor of NSSI, with an AUC value of 0.780.

CONCLUSION

NSSI was common in depressed adolescents and linked to CM and high levels of IL-1β. These results indicated that CM and inflammatory cytokines play an important role in the development of NSSI. In the future, interventions and modulations based on CM and inflammation levels may help treat NSSI in adolescents with MDD.