Factors influencing non-suicidal self-injury in adolescents with mood disorders: Focusing on gender differences and only-child vs non-only-child disparities

doi:10.5498/wjp.v16.i8.116277

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Aug 19, 2026; 16(8): 116277
Published online Aug 19, 2026. doi: 10.5498/wjp.v16.i8.116277

Factors influencing non-suicidal self-injury in adolescents with mood disorders: Focusing on gender differences and only-child vs non-only-child disparities

Xiao-Yu Qiang, Jin-Hua Liu, Xiu-Hua Song

Xiao-Yu Qiang, School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China

Jin-Hua Liu, Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215131, Jiangsu Province, China

Xiu-Hua Song, Department of Psychiatry, Mental Health Center of Qingdao City, Qingdao 266034, Shandong Province, China

Co-first authors: Xiao-Yu Qiang and Jin-Hua Liu.

Author contributions: Qiang XY and Song XH contributed to validation, supervision, visualization, review and editing; Qiang XY and Liu JH contributed equally to this manuscript as co-first authors; Liu JH contributed to conceptualization, data curation, investigation, methodology, and original draft. All authors have read and approved the final manuscript.

AI contribution statement: During the preparation of this manuscript, the authors used ChatGPT solely for language polishing and translation assistance. No AI tools were used to generate scientific content, data analysis, study design, result interpretation, or images, and the authors take full responsibility for the originality and integrity of the work.

Institutional review board statement: This study was approved by the Ethics Committee of Suzhou Guangji Hospital (approval No. SGH-ER-2023-069). All methods were carried out in accordance with the Declaration of Helsinki.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The datasets used and analysed during the current study are available from the corresponding author on reasonable request.

Corresponding author: Xiao-Yu Qiang, School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, No. 1200 Cailun Road, Pudong New Area, Shanghai 201203, China. qiangxiaoyu182@163.com

Received: November 11, 2025
Revised: January 7, 2026
Accepted: April 1, 2026
Published online: August 19, 2026
Processing time: 254 Days and 5.6 Hours

Abstract

BACKGROUND

Non-suicidal self-injury (NSSI) refers to intentional, self-inflicted damage to body tissues without suicidal intent and for non-socially sanctioned purposes. It has become a pressing global public health issue, particularly among adolescents with mood disorders.

AIM

To investigate the prevalence of NSSI in adolescents with mood disorders and identify key influencing factors, with a focus on gender and sibling status (only-child vs non-only-child).

METHODS

A cross-sectional study was conducted among 620 adolescents (12-18 years) diagnosed with mood disorders, who were recruited from psychiatric clinics. Sociodemographic, clinical, psychological, and family functioning data were collected using standardized questionnaires. Univariate analyses and binary logistic regression were applied to explore factors associated with NSSI.

RESULTS

The overall prevalence of NSSI was 72.26%. Multivariate regression identified female gender [odds ratio (OR) = 1.87, 95% confidence interval (CI): 1.24-2.82], only-child status (OR = 1.54, 95%CI: 1.03-2.29), longer mood disorder duration (OR = 1.08, 95%CI: 1.04-1.12), comorbid obsessive-compulsive symptoms (OR = 2.13, 95%CI: 1.38-3.29), low self-warmth (OR = 0.92, 95%CI: 0.89-0.94), and poor family cohesion (OR = 0.94, 95%CI: 0.91-0.96) as independent predictors. Gender and sibling status also moderated the frequency and methods of NSSI: Females and only-children exhibited a higher NSSI frequency and preferred cutting/scratching, while males favored hitting/head-banging.

CONCLUSION

NSSI is highly prevalent in adolescents with mood disorders. Gender and sibling status are significant sociodemographic predictors, with distinct psychosocial mechanisms contributing to the risk of NSSI. Tailored interventions that address these factors may help reduce the burden of NSSI in this population.

Keywords: Non-suicidal self-injury; Adolescents; Mood disorders; Gender difference; Sibling status

Core Tip: This study investigated non-suicidal self-injury in 620 adolescents with mood disorders, highlighting the roles of gender and sibling status. Female and only-child adolescents exhibited higher non-suicidal self-injury prevalence and frequency, with distinct psychological and familial predictors. Findings emphasize the importance of gender- and sibling-specific screening and interventions, including trauma-informed care, self-compassion training, cognitive reappraisal, and family support enhancement, to prevent and mitigate self-injurious behaviors in this vulnerable population.