| Objective: Adolescent non-suicidal self-injury（NSSI）has attracted extensive attention in the field of mental health,become a major public health problem,and has been a research hotspot.This study compared the differences of thyroid hormone level,sex hormone level and cognitive function in adolescents with or without NSSI behavior,and explored the correlation between thyroid hormone level,sex hormone level,cognitive function and NSSI behavior in depressive disorder adolescents,in order to find the risk factors and potential biological markers for early identification of NSSI in depressive disorder adolescents.Methods: In this study,adolescents aged 12-18 with depressive disorder were studied.A total of 153 adolescent patients who met the diagnostic criteria of depressive disorder in DSM-5（Diagnostic and Statistical Manual of Mental Disorders,5th Edition）and were hospitalized in Shandong Mental Health Center from December 2020 to December 2021 were selected.According to the diagnosis of "NSSI" in DSM-5,83 patients with depressive disorder who were consistent with NSSI behaviors were enrolled as the study group and 70 patients without NSSI behaviors were enrolled as the control group.The general data of the enrolled patients were collected.Subsequently,the patients were evaluated with the Ottawa self-injury inventory（OSI）,Self-Rating Anxiety Scale（SAS）,Montgomery-Asberg Depression Rating Scale（MADRS）and Perceived Deficit Questionnaire for Depression（PDQ-D-20）.Last,the levels of six levels of fasting venous blood sex hormones and five levels of thyroid in the morning after admission were measured and analyzed.SPSS25.0 statistical software was used to conduct correlation analysis on the general data,gonadal hormone and thyroid hormone levels and scores of each scale.Results:1.The age and educated time of the study group were lower than that of the control group（P<0.05）.There were no differences in the rate of first episode between the two groups.2.Evaluation of depression,anxiety and cognitive function: the MADRS scores,SAS scores,PDQ-D-20 total scores,attention/concentration,retrospective memory,planning/organization scores of the study group were higher than those of the control group（P <0.05）.3.Thyroid hormone and sex hormone levels: Serum FT4（free thyroxine）concentration in the study group was lower than that in the control group,while serum PRL（prolactin）concentration was higher than that in the control group（P<0.05）.Female: serum FT4 concentration in the study group was lower than that in the control group,while serum free triiodothyronine（FT3）concentration in the study group were higher than that in the control group（P<0.05）.Male: the serum concentrations of estradiol（E2）,progesterone（Prog）and PRL in the study group were higher than those in the control group（P<0.05）.4.Correlation between cognitive function and thyroid hormone level and sex hormone level: The total cognitive function score of the study group was correlated with the age of first NSSI（P<0.05）,and had no correlation with gender,age,educational background and first incidence rate.In the study group,attention/concentration,prospective memory,retrospective memory,planning/organization scores and PDQ-D-20 total scores were positively correlated with MADRS scores and SAS scores（P<0.001）.SAS scores accounted for 52.1 percent of the cognitive impairment in the study group.The total scores of PDQ-D-20,retrospective memory and planning/organization scores were correlated with serum T concentration（P<0.05）,but not with serum total triiodothyronine（TT3）,FT3,total thyroxine（TT4）,FT4,thyroid-stimulating hormone（TSH）,E2,Prog,luteinzing hormone（LH）,follicle-stimulating hormone（FSH）,PRL concentration.5.The related factors of repeat NSSI in recent 1 month: the age of first NSSI in the group with repeat NSSI in recent 1 month was lower than that in the group without repeat NSSI in recent 1 month（P<0.05）.There were no differences in gender,age and causes of NSSI between the two groups.There were no differences in MADRS scores,SAS scores and PDQ-D-20 total scores between the two groups.Compared with the group without repeat NSSI in recent 1 month,serum TSH concentration in the group with repeat NSSI in recent 1month was increased,while serum E2 and Prog concentration were decreased（P<0.05）.Conclusion:1.The impairment of cognitive function in the adolescents with NSSI behavior was more serious than that in the adolescents without NSSI behavior.2.Serum FT4 and PRL concentrations were correlated with NSSI behavior in adolescents with depressive disorder.3.The lower the serum T concentration,the more impaired the cognitive function.4.The cognitive impairment may be risk factors for depressive disorder adolescents engaging in NSSI behavior.5.The more severe depression and anxiety were in the NSSI group,the more serious the impairment of cognitive function was. |
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