Effect of theory of mind on non-suicidal self-injury behavior in adolescent patients with depressive disorder for the first hospitalization / 中华行为医学与脑科学杂志

ABSTRACT

Objective:To explore the characteristics of theory of mind(TOM) ability of adolescent depressive disorder patients with non-suicidal self-injury (NSSI) behavior, and analyze the relationship between NSSI behavior and TOM, so as to identify patients with NSSI behavioral risk early and give timely intervention.Methods:A total of 54 adolescent patients with depressive disorder who were hospitalized for the first time in Shenzhen Kangning Hospital from May to October 2021 were enrolled.They were divided into NSSI group( n=31)and non-NSSI group( n=23)according to DSM-5.Hamilton anxiety rating scale-14 item (HAMA-14) and Hamilton depression rating scale-17 item(HAMD-17)were used to evaluate the severity of anxiety and depression.Hinting task, Yoni task and reading the mind in the eyes test(RMET) were used to test TOM of the two groups.Binary Logistic regression analysis in SPSS 22.0 was used to explore the influence of TOM ability on NSSI behavior of adolescents with depressive disordor. Results:Compared with patients in non-NSSI group, patients in NSSI had significantly higher scores of HAMA-14(21.48±4.92 vs 16.35±5.61, t=3.57, P<0.05) and HAMD-17(25.61±4.08 vs 21.43±4.64)( t=3.51, P<0.05). The patients in NSSI group had lower scores on the hinting task(16.10±2.84 vs 18.17±1.15, t=-3.68, P<0.05), RMET task (21.61±2.58 vs 23.61±3.07)( t=-2.59, P<0.05), and second-order cognitive TOM((18.90±3.70) vs (20.96±2.72), t=-2.27, P<0.05) and second-order affective TOM(28.84±3.93 vs 31.04±3.04)( t=-2.24, P<0.05) in Yoni task than those in non-NSSI group.Binary Logistic regression analysis showed effective TOM ( β=-0.306, OR=0.736, 95% CI= 0.552-0.982, P=0.037)and cognitive TOM ( β=-0.485, OR=0.616, 95% CI=0.396-0.957, P=0.031) were associated with non-suicidal self-injury in patients with depressive disorder. Conclusion:The increased impairment of the emotional component (decoding component) and cognitive component (reasoning component) of TOM may be risk factors for the occurrence of NSSI behavior in adolescent depressive disorder patients.