Psychological Characteristics and Pain Tolerance of Adolescents with Depression Experiencing Self-injury or Suicidality

Linyuan XU; Huajun ZHAO; Chao LI; Yan SU; Shihua BAO; Lei WU; Qingwei LI; Bingkui ZHANG

doi:10.12259/j.issn.2095-610X.S20250109

Volume 46 Issue 1

Jan. 2025

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Linyuan XU, Huajun ZHAO, Chao LI, Yan SU, Shihua BAO, Lei WU, Qingwei LI, Bingkui ZHANG. Psychological Characteristics and Pain Tolerance of Adolescents with Depression Experiencing Self-injury or Suicidality[J]. Journal of Kunming Medical University, 2025, 46(1): 68-77. doi: 10.12259/j.issn.2095-610X.S20250109

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Psychological Characteristics and Pain Tolerance of Adolescents with Depression Experiencing Self-injury or Suicidality

doi: 10.12259/j.issn.2095-610X.S20250109

1.
Department of Medical Rehabilitation，Kunming Psychiatric Hospital，Kunming Yunnan 650231
2.
Department of Geriatric Psychiatry，Affiliated Center of Mental Health of Kunming Medical University，Kunming Yunnan 650224，China

Received Date: 2024-08-24
Available Online: 2024-12-14
Publish Date: 2025-01-17

Abstract

Abstract

Objective To explore the influencing factors of self injury or suicide in adolescent patients with depression. Methods A total of 96 adolescents who were diagnosed with depressive disorder at Yunnan Psychiatirc Hospital and Kunming Psychiatirc Hospital from January 2023 to May 2024 were selected for the study. The case group consisted of 61 adolescents who had self-injury or suicidal behaviors within 30 days, while the control group consisted of 35 adolescents who had no self-injury or suicidal behaviors within at least 30 days. Assessments were performed using the Patient Health Questionnaire-9 （PHQ-9）, Millon Screening Inventory for Borderline Personality Disorder （MSI-BPD）, House-Tree-Person Drawing Test （HTP）, and the Columbia Suicide Severity Rating Scale （C-SSRS）. Among these, 72 subjects underwent skin pressure pain threshold testing using the Algometer HP-50, with 12 in the self-harm or suicide group within 2 days and 60 in the group beyond 2 days. Results （1） Analysis of gender and age between the two groups showed statistically significant differences （P < 0.05）, with a higher proportion of females and younger ages in the 30-day group; （2） The PHQ-9 score for the 30-day group was （19.59±5.99）, with a score of （2.41±0.97） for item 9 （"Thoughts that it would be better to be dead or to hurt oneself in some way"）, and an MSI-BPD score of （7.43±1.61）. The scores for the group over 30 days were （10.89±7.99）, （1.00±1.11） for item 9, and （5.40±3.13） for MSI-BPD. Independent samples t-test analysis showed significant differences （P < 0.01）; （3） In the 30-day group, five drawing characteristics from the 47 HTP characteristics （shift of center of gravity, hair not disheveled or no hair, no mountains, no sun, and no flowers or grass） were found to occur at a higher rate, with statistical significance （P < 0.05）; （4） In the binary logistic regression analysis of 96 patients with the 30-day suicide or self-injury behavior as the dependent variable, the absence of flowers and PHQ-9 question 9 score are the risk factors for adolescent depression patients to have self-injury or suicide behavior within 30 days （OR _{no flowers} = 7.934, OR _{score on PHQ-9 question 9} = 3.554）. （5） Among the 72 subjects the skin pressure pain threshold for adolescents who exhibited self-injure or suicide behaviors within 2 days （8.83±4.27 N） was significantly higher than that for patients beyond 2 days （6.48±3.00 N）, with statistical significance （t = -2.201, P < 0.05）. Additionally, the score for item 9 of the PHQ-9 was higher （2.50±0.67 vs 1.87±0.95）, also showing statistical significance （t = -2.201, P < 0.05）. Conclusion The absence of flowers or grass in HTP painting, and stronger suicidal ideation or suicide attempt are risk factors for self-injury or suicidal behavior in adolescents with depression. Furthermore, those who self-injure or commit suicide within 2 days have a higher pain threshold compared to those beyond 2 days.
- Adolescent depression disorder,
- Self-injure or suicidal behavior,
- House-tree-person test,
- Painthreshold

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References(23)

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