Suicide attempt predictors among adolescents exhibiting non-suicidal self-injury: A six-week follow-up open study

Abstract

BACKGROUND

Non-suicidal self-injury (NSSI) in adolescents is a strong predictor of suicide and a significant mental health problem worldwide. Previous studies have identified various risk factors for NSSI. However, studies have not explored the association between inflammatory factors and NSSI in adolescents.

AIM

To investigate inflammatory marker changes post-antidepressant treatment and their association with suicide risk in NSSI adolescents.

METHODS

The study enrolled 68 adolescents with NSSI behaviors. The participants were divided into high and low suicide risk groups (n = 38 and n = 30, respectively) based on their scores on the Suicide Risk Factors Assessment Scale. Symptom severity was assessed at baseline and after six weeks of treatment. Blood samples were obtained to monitor for inflammatory factors.

RESULTS

The high suicide risk group exhibited higher levels of interferon (IFN)-α and interleukin (IL)-10 than the low suicide risk group. Scores on the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Insomnia Severity Index decreased significantly post-treatment. Tumor necrosis factor-α, IL-10, IL-6, IL-1, and IL-12 levels decreased, whereas IFN-γ, IL-4, and IFN-α levels increased. IL-10 levels were correlated with the severity of suicide risk factors.

CONCLUSION

Adolescents with NSSI exhibit distinct inflammatory markers based on suicide risk, which change following treatment. Moreover, IL-10 levels are associated with suicide risk. These biomarkers may help assess suicide risk in clinical settings.

Keywords: Adolescents; Non-suicidal self-injury; Inflammatory factors; Suicide risk; Antidepressant treatment

Core Tip: This observational study explores the link between inflammatory markers and suicide risk in Chinese adolescents with non-suicidal self-injury, alongside antidepressant treatment effects. Key findings reveal distinct inflammatory profiles stratified by suicide risk levels, with specific cytokines correlating to risk severity. Critically, antidepressant intervention modulates inflammatory expression while improving clinical symptoms. The study identifies a potential inflammatory biomarker for suicide risk assessment in non-suicidal self-injury adolescents, offering a novel biological perspective for clinical risk stratification and treatment monitoring.