Zhang Xinshang,Zheng Hongyu,Wu Ming,Hou Tao,Mo Daming,Non-suicidal self-injury behavior in adolescent patients with depressive disorders: the influence of interoceptive awareness and related factors[J].SICHUAN MENTAL HEALTH,2025,(6):491-497
Non-suicidal self-injury behavior in adolescent patients with depressive disorders: the influence of interoceptive awareness and related factors
DOI:10.11886/scjsws20250110003
English keywords:Adolescents  Depressive disorder  Non-suicidal self-injury behaviors  Interoceptive awareness  Correlation
Fund projects:国家级临床重点专科建设项目经费资助;安徽省临床重点专科建设项目经费资助;合肥市第四人民医院院级科研项目(项目名称:青少年抑郁障碍患者自杀、自伤行为与内感受功能相关研究,项目编号:HFSY2022YB07)
Author NameAffiliationPostcode
Zhang Xinshang Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China
The Fourth People's Hospital of Hefei, Hefei 230022, China 
230022
Zheng Hongyu Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China
The Fourth People's Hospital of Hefei, Hefei 230022, China 
230022
Wu Ming Affiliated Psychological Hospital of Anhui Medical University, Hefei 230022, China
The Fourth People's Hospital of Hefei, Hefei 230022, China 
230022
Hou Tao The Fourth People's Hospital of Hefei, Hefei 230022, China
School of Mental Health, Bengbu Medical University, Bengbu 233030, China 
233030
Mo Daming* Anhui No.2 Provincial People's Hospital, Hefei 230011, China 230011
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English abstract:
      Background Non-suicidal self-injury (NSSI) represents a prevalent clinical feature among adolescent patients with major depressive disorder. Existing research has suggested that interoceptive awareness might be linked to NSSI behaviors, but investigations into this association among adolescent patients with major depressive disorders remain limited.Objective To elucidate the correlation between NSSI behaviors and interoceptive awareness in adolescent patients with major depressive disorder, and to identify influencing factors of NSSI behaviors, in order to provide clinical prevention and treatment strategies.Methods A total of 125 adolescent patients who met the diagnostic criteria for major depressive disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) were recruited from the Fourth People's Hospital of Hefei from December 2022 to June 2024. These participants were subsequentially categorized into NSSI behavior group (n=60) and non-NSSI behavior group (n=65) based on the presence or absence of NSSI behaviors. Additionally, a control group comprising 40 healthy adolescents was concurrently assembled for comparison. The Hamilton Depression Scale-17 item (HAMD-17) was used to assess the depressive symptoms of adolescent patients with major depressive disorder, and the Multidimensional Assessment of Interoceptive Awareness version 2- Chinese (MAIA-2) was used to evaluate the interoceptive awareness level of all subjects. Pearson correlation analysis was employed to examine the correlation between HAMD-17 scores and MAIA-2 scores. Binary Logistic regression analysis was conducted to identify the influencing factors of NSSI behaviors in adolescent patients. Then the receiver operating characteristic (ROC) curve was drawn to verify the predictive efficacy of MAIA-2 scores for NSSI behaviors in adolescent patients with major depressive disorder.Results Significant differences were identified across six MAIA-2 subscales (noticing, not distracting, not worrying, attention regulation, emotional awareness, body listening) and the MAIA-2 total score among the three groups (F=18.475, 20.631, 6.044, 5.621, 18.456, 12.889, 12.741, P<0.01). Correlation analysis underscored a notable negative correlation between the MAIA-2 total score and the HAMD-17 total score, as well as its scores on subscales pertaining to weight and cognitive impairment factors(r=-0.315, -0.203, -0.278, P<0.05). Binary Logistic regression results indicated that longer disease duration (OR=1.112, 95% CI: 1.043–1.206) and higher HAMD-17 total score (OR=2.071, 95% CI: 1.361–3.150) were risk factors for NSSI behavior in adolescents with depressive disorder, while a higher MAIA-2 total score was a protective factor against NSSI behavior in this population (OR=0.580, 95% CI: 0.407–0.828). The MAIA-2 total score demonstrated a relatively high predictive value for NSSI behaviors in adolescent patients with major depressive disorder (AUC=0.793).Conclusion NSSI behaviors in adolescent patients with major depressive disorder are closely related to the disease course, severity of depression, and specific interoceptive awareness patterns. Moreover, interoceptive awareness may serve as a predictive indicator for the occurrence of their NSSI behaviors. [Funded by the National Key Clinical Specialty Construction Project of China; Anhui Provincial Clinical Key Specialty Construction Project; the Hospital-Level Scientific Research Project of the Fourth People's Hospital of Hefei (number, HFSY2022YB07)]
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