Correlation Between Non-suicidal Self-injury Behavior And Social Psychological Factors Of Adolescent Inpatients With Major Depressive Disorder

Objective:To explore the current situation of non-suicidal self-injury behavior in hospitalized adolescents with depression and the influencing factors such as personality characteristics,childhood abuse,family function,and life events,etc.The aim is to provide a reference for early prevention,early identification and early intervention of non-suicidal self-injury behavior in adolescents.Methods:This study included 120 adolescent patients with depression who were admitted to the Psychiatric Department of the First Affiliated Hospital of Shanxi Medical University and met the admission criteria.They were divided into non-suicidal behavior group(n=29),Non-suicidal self-injury(NSSI)group(n=65),Suicide attempt(SA)group(n=26).We used a self-made general situation questionnaire to collect the general demographic data of participants,and conducted semi-structured interviews on selfinjury to obtain relevant information.Using the Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD-24),Life Events Scale(ASLEC),Life Events Scale(LES),Eysenck Personality Questionnaire(EPQ),Young Internet Addiction Test(IAT),Childhood Abuse Questionnaire(CTQ),Family Function Rating Scale(FAD),Self-Esteem Scale(SES)and Adolescent Interpersonal Relationship Comprehensive Diagnostic Scale(ICDS)to assess the emotional and psychosocial factors of patients.SPSS25.0 software was used for data analysis: The conforming normal distribution data were expressed as((?)±s),and the intergroup comparisons were expressed as oneway ANOVA;the non-normally distributed data were expressed as M(P25～P75),and non-parametric tests were used for inter-group comparisons.The counting data were expressed in terms of the number of people(composition ratio,%),and the chi-square test was used for intergroup comparisons;multivariate logistic regression to analyze the factors related to self-injury suicide;and the difference between P<0.05 was statistically significant.Result:1.Among the 120 adolescent depressive patients in this study,65 had NSSI behavior with a detection rate of 54.17%,and 26 people with SA behavior had a detection rate of 21.67%.15-17 years old is the age group with a high incidence of NSSI behavior,14-17 years old is the age group with a high incidence of SA behavior,and more women than men have self-injurious suicide behavior.There was no significant difference in age,gender,educational level,religious belief,family location,whether they were an only child,whether they lived with their parents during childhood,whether the current living with their biological parents,their parents’ educational level,the relationship with their parents,family economic status and school bullying(P>0.05)for the three groups.2.According to the semi-structured interview results,among the 65 adolescents with NSSI behaviors,the most frequently used method of self-injury was cutting and stabbing themselves with a knife or a sharp instrument,with a total of 47 cases(72.3%).The next one was picking or scratching themselves,with a total of 34 cases(52.3%).Followed by hitting the wall/hammering the wall in 29 cases(44.6%),biting themselves hard in 20 cases(30.8%),and pulling hair hard in 14 cases(21.5%).In terms of the time of self-injury,28 cases(43.1%)had self-injured behavior in the past 1 month;14 cases(21.5%)had self-injured behavior in the past 1 week;13 cases(20%)had self-injured behavior in the past six months behavior.The top three reasons for self-injury were school factors,family factors,and academic factors.61.5% of adolescents with depression feel relaxed and happy after self-injury.3.Among the adolescents with depression,the scores of depression and anxiety in the non-self-injured suicidal behavior group,NSSI group,and SA group gradually increased,and the SA group and the non-self-injured suicidal behavior group had statistically significant differences in HAMD-24 and HAMA scores(P<0.05).The scores of neuroticism,psychoticism,emotional abuse,physical abuse,emotional neglect,behavioral distress in conversation,friendship,communication,role,emotional involvement and general functioning,interpersonal relationship,punishment,LES negative events and IAT scale in the NSSI group and the SA group were higher than those of the non-self-injured suicidal behavior group.The scores of extroversion and SES scale in the NSSI group and SA group were lower than those in the non-self-injured suicidal behavior group.The SA group scored significantly higher on physical abuse and emotional neglect than the NSSI group,The NSSI group had higher learning stress scores than the non-self-injured suicidal behavior group.The differences between the above groups were statistically significant.(P<0.05)。4.Logistic regression analysis showed that: psychoticism,LES negative events,physical abuse,and internet addiction were risk factors for self-injury and suicidal behavior,and the degree of self-esteem was a protective factor.Conclusion:1.The incidence of NSSI behavior in adolescent inpatients with depression is higher.The 15-17 year old is the age group with high incidence of NSSI behavior,and the 14-17 year old is the age group with high incidence of SA behavior.Self-injurious suicidal behavior is more common in women than in men.The most common way of self-injury is to cut themselves with sharp weapon.2.The self-injury and suicidal behaviors of adolescents with depression are related to introversion,neuroticism,psychoticism,emotional abuse,physical abuse,emotional neglect,friendship,interpersonal relationships,study pressure,punishment,communication and other aspects.Psychoticism,LES negative events,physical abuse,and internet addiction were risk factors for self-injury and suicidal behavior,and the degree of self-esteem was a protective factor.