Distinct correlation network of clinical characteristics in suicide attempters having adolescent major depressive disorder with non-suicidal self-injury.

Suicidal behavior and non-suicidal self-injury (NSSI) are common in adolescent patients with major depressive disorder (MDD). Thus, delineating the unique characteristics of suicide attempters having adolescent MDD with NSSI is important for suicide prediction in the clinical setting. Here, we performed psychological and biochemical assessments of 130 youths having MDD with NSSI. Participants were divided into two groups according to the presence/absence of suicide attempts (SAs). Our results demonstrated that the age of suicide attempters is lower than that of non-attempters in participants having adolescent MDD with NSSI; suicide attempters had higher Barratt Impulsiveness Scale (BIS-11) impulsivity scores and lower serum CRP and cortisol levels than those having MDD with NSSI alone, suggesting levels of cortisol and CRP were inversely correlated with SAs in patients with adolescent MDD with NSSI. Furthermore, multivariate regression analysis revealed that NSSI frequency in the last month and CRP levels were suicidal ideation predictors in adolescent MDD with NSSI, which may indicate that the increased frequency of NSSI behavior is a potential risk factor for suicide. Additionally, we explored the correlation between psychological and blood biochemical indicators to distinguish suicide attempters among participants having adolescent MDD with NSSI and identified a unique correlation network that could serve as a marker for suicide attempters. Our research data further suggested a complex correlation between the psychological and behavioral indicators of impulsivity and anger. Therefore, our study findings may provide clues to identify good clinical warning signs for SA in patients with adolescent MDD with NSSI.

Childhood Maltreatment, Low Serum Cortisol Levels, and Non-Suicidal Self-Injury in Young Adults With Major Depressive Disorders.

Background: 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. Methods: 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. Results: 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. Conclusion: 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.