Psychopathological correlates of depression with non-suicidal self-harm in non-psychotic mental illnesses of adolescence

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OBJECTIVE

To determine the main clinical and psychopathological features of the relationship between depressive states and non-suicidal self-injury (NSSI) in mental illnesses of the non-psychotic register in adolescence.

MATERIAL AND METHODS

Clinical data of 128 patients (77 males and 51 females), who presented with depressive states and NSSI in non-psychotic mental disorders during adolescence, were analyzed. The patients were examined at the Clinic of the Mental Health Research Center during the period 2020—2023. The mean age of the patients was 19±4.1 years.

RESULTS

Based on the data from studying depression and NSSI in adolescence, we developed a typology, identifying three variants of affect and auto-aggressive activity interactions. The affect-dominant type (25.8%) was characterized by a predominance of affective pathology (p<.05), with the occurrence of impulsive NSSI (45.5%) and demonstrative NSSI (30.3%) (p<0.05). The personality-dominant type (43.0%) was based on pathocharacterological abnormalities (60.0%), where NSSI were represented by impulsive (25.5%), depersonalizing (27.3%), and addictive variants (32.7%) (p<0.05). The reciprocal type (31.3%) exhibited pronounced polymorphism, combining high affect variability with a tendency towards auto-aggressive behavior of varying severity and manifestations of NSSI (p<0.05). In terms of nosological distribution, schizotypal disorder predominated (45.0%) followed by predominantly borderline personality disorder (30.0%) and bipolar affective disorder (25.0%) (p<0.05). In terms of nosological distribution, schizotypal disorder predominated (45.0%), followed by predominantly borderline personality disorder (30.0%) and bipolar affective disorder (25.0%) (p<0.05).

CONCLUSION

Three types of correlation between depression and NSSI were identified, the formation of which was due to the pathoplastic influence of the age factor, nosological affiliation and a certain, including pathological personality structure. Statistically significant regularities between variants of NSSI and types of their interrelation were revealed. The results can be considered as differential diagnostic and prognostic markers of their further trajectories and, therefore, contribute to the creation of new therapeutic strategies, timely diagnosis and earlier intervention.

Keywords:

depression

non-suicidal self-injury

bipolar affective disorder

schizotypal disorder

personality disorder

adolescence

Authors:

Krylova E.S.

Mental Health Research Center

ORCID: 0000-0002-6644-5454

Kuleshov A.A.

Mental Health Research Center

ORCID: 0000-0002-2288-202X

Kaleda V.G.

Mental Health Research Centre

SPIN RSCI: 9035-3290
Scopus AuthorID: 56765570100
ResearcherID: K-5466-2013
ORCID: 0000-0002-1209-1443

Received:

22.06.2023

Accepted:

14.09.2023

List of references:

Mars B, Heron J, Klonsky ED, et al. Predictors of future suicide attempt among adolescents with suicidal thoughts or non-suicidal self-injury: a population-based birth cohort study. The Lancet Psychiatry. 2019;6(4):327-337. https://doi.org/10.1016/S2215-0366(19)30030-6
Rajhvajn Bulat L, Sušac N, Ajduković M. Predicting prolonged non-suicidal self-injury behaviour and suicidal ideations in adolescence — the role of personal and environmental factors. Current Psychology. Published online 2023:1-12. https://doi.org/10.1007/s12144-023-04404-8
Grossberg A, Rice T. Depression and Suicidal Behavior in Adolescents. The Medical clinics of North America. 2023;107(1):169-182. https://doi.org/10.1016/j.mcna.2022.04.005
World Health Organization. Mental health atlas 2020. Geneva: World Health Organization, 2021. https://apps.who.int/iris/handle/10665/345946
Oderinde KO, Dada MU, Ogun OC, et al. Prevalence and Predictors of Depression among Adolescents in Ido Ekiti, South West Nigeria. International Journal of Clinical Medicine. 2018;09(03):187-202. https://doi.org/10.4236/ijcm.2018.93017
Shorey S, Ng ED, Wong CHJ. Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis. The British Journal of Clinical Psychology. 2022;61(2):287-305. https://doi.org/10.1111/bjc.12333
Lisiecka-Biełanowicz M, Biechowska D, Orłowska E, et al. The prevalence of depression in children and adolescents under 18 years of age treated for mental disorders in Poland between 2005 and 2016. Archives of Medical Science: AMS. 2023;19(2):371-380. https://doi.org/10.5114/aoms.2020.94530
Wang YJ, Li X, Ng CH,et al. Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis. eClinicalMedicine. 2022;46:1-12. https://doi.org/10.1016/j.eclinm.2022.101350
Stead VE, Boylan K, Schmidt LA. Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents. Borderline Personality Disorder and Emotion Dysregulation. 2019;6(1):1-12. https://doi.org/10.1186/s40479-019-0100-9
Kuleshov AA, Krylova ES, Beburishvili AA, Kaleda VG. Dynamics of autoagressivebehavior in youth in the trajectory of borderline personality disorder. V.M. Bekhterev Review of Psychiatry Andmedical Psychology. 2022;56(4):77-84. (In Russ.). https://doi.org/10.31363/2313-7053-2022-4-77-84
Buelens T, Costantini G, Luyckx K, et al. Comorbidity Between Non-suicidal Self-Injury Disorder and Borderline Personality Disorder in Adolescents: A Graphical Network Approach. Frontiers in psychiatry. 2020;11:580922. https://doi.org/10.3389/fpsyt.2020.580922
Konac D, Young KS, Lau J, et al. Comorbidity Between Depression and Anxiety in Adolescents: Bridge Symptoms and Relevance of Risk and Protective Factors. Journal of psychopathology and Behavioral Assessment. 2021;43(3):583-596. https://doi.org/10.1007/s10862-021-09880-5
Calarco CA, Lobo MK. Depression and substance use disorders: Clinical comorbidity and shared neurobiology. International Review of Neurobiology. 2021;157:245-309. https://doi.org/10.1016/bs.irn.2020.09.004
Moran P, Coffey C, Romaniuk H, et al. The natural history of self-injury from adolescence to young adulthood: a population-based cohort study. Lancet (London, England). 2012;379(9812):236-243. https://doi.org/10.1016/S0140-6736(11)61141-0
Burke TA, Piccirillo ML, Moore-Berg SL, et al. The stigmatization of nonsuicidal self-injury. Journal of Clinical Psychology. 2019;75(3):481-498. https://doi.org/10.1002/jclp.22713
Muehlenkamp J, Brausch A, Quigley K,et al. Interpersonal features and functions of nonsuicidal self-injury. Suicide & Life-Threatening Behavior. 2013;43(1):67-80. https://doi.org/10.1111/j.1943-278X.2012.00128.x
Victor SE, Hipwell AE, Stepp SD, et al. Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset. Child and Adolescent Psychiatry and Mental Health. 2019;13:1. https://doi.org/10.1186/s13034-018-0261-0
Wilkinson PO, Qiu T, Neufeld S, et al. Sporadic and recurrent non-suicidal self-injury before age 14 and incident onset of psychiatric disorders by 17 years: prospective cohort study. The British Journal of Psychiatry: the Journal of Mental Science. 2018;212(4):222-226. https://doi.org/10.1192/bjp.2017.45
Krylova ES. Depression in patients with personality disorder in youth. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2018;118(8):4-10. (In Russ.). https://doi.org/10.17116/jnevro20181180814
Wichstrøm L. Predictors of non-suicidal self-injury versus attempted suicide: similar or different? Archives of Suicide Research: Official Journal of the International Academy for Suicide Research. 2009;13(2):105-122. https://doi.org/10.1080/13811110902834992
Campos AI, Verweij KJH, Statham DJ, et al. Genetic aetiology of self-injury ideation and behaviour. Scientific Reports. 2020;10(1):9713. https://doi.org/10.1038/s41598-020-66737-9
Başgöze Z, Wiglesworth A, Carosella KA, et al. Depression, Non-Suicidal Self-Injury, and Suicidality in Adolescents: Common and Distinct Precursors, Correlates, and Outcomes. Journal of Psychiatry and Brain Science. 2021;6(5):e210018. https://doi.org/10.20900/jpbs.20210018
Thapar A, Collishaw S, Pine DS, et al. Depression in adolescence. Lancet (London, England). 2012;379(9820):1056-1067. https://doi.org/10.1016/S0140-6736(11)60871-4
Alaie I, Ssegonja R, Philipson A, et al. Adolescent depression, early psychiatric comorbidities, and adulthood welfare burden: a 25-year longitudinal cohort study. Social Psychiatry and Psychiatric Epidemiology. 2021;56(11):1993-2004. https://doi.org/10.1007/s00127-021-02056-2
Johnson D, Dupuis G, Piche J, et al. Adult mental health outcomes of adolescent depression: A systematic review. Depression and Anxiety. 2018;35(8):700-716. https://doi.org/10.1002/da.22777
Clayborne ZM, Varin M, Colman I. Systematic Review and Meta-Analysis: Adolescent Depression and Long-Term Psychosocial Outcomes. Journal of the American Academy of Child and Adolescent Psychiatry. 2019;58(1):72-79. https://doi.org/10.1016/j.jaac.2018.07.896
Krylova ES, Beburishvili AA, Kaleda VG. Non-suicidal self-injury and its relation to suicidal behavior in youth patients with personality disorders. Suicidology. 2019;01(34):48-57. (In Russ.). https://doi.org/10.32878/suiciderus.19-10-01(34)-48-57
Wedig MM. Psychological Meanings and Functions of Non-suicidal Self-Injury and Eating Disorders BT — Non-Suicidal Self-Injury in Eating Disorders: Advancements in Etiology and Treatment. In: Claes L, Muehlenkamp JJ, eds. Non-Suicidal Self-Injury in Eating Disorders. Berlin, Heidelberg: Springer; 2014:73-84. https://doi.org/10.1007/978-3-642-40107-7_5

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