Associations of depressive and anxiety symptoms with non-suicidal self-injury and suicidal attempt among Chinese adolescents: The mediation role of sleep quality

Abstract

BackgroundAssociations of depressive and anxiety symptoms with non-suicidal self-injury (NSSI) and suicide attempt (SA) are not well understood. We aimed to examine these associations among Chinese adolescents, and whether any potential association is mediated through sleep quality.MethodsWe conducted a cross-sectional study among 1,771 (994 boys [56.1%] and 777 girls [43.9%], mean [SD] age was 12.9 [0.6] years) adolescents who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort (CAHGC) study. Depressive symptoms, anxiety symptoms, NSSI, SA and sleep quality were measured by validated questionnaire. Logistic regression models were employed to estimate the associations of depression and anxiety with NSSI and SA. Mediation analyses were conducted to explore the mediate effect of sleep quality.ResultsThe 12-month prevalence of NSSI and SA was 17.1 and 8.3%, respectively. Depressive and anxiety symptoms were significantly associated with NSSI (the adjusted odds ratio [aOR] was 1.89 [95% CI 1.34–2.65] for depressive symptoms and 2.84 [95% CI 2.05–3.94] for anxiety symptoms) and SA (the aOR was 3.20 [95% CI 2.03–5.05] for depressive symptoms and 2.98 [95% CI 1.84–4.84] for anxiety symptoms). No significant gender differences were found in the associations. The mediation proportion of sleep quality on the association of depressive and anxiety symptoms with NSSI, as well as depressive and anxiety symptoms with SA were 21.1, 13.9, 13.6, and 14.7, respectively.ConclusionIndependent associations of depressive and anxiety symptoms with NSSI and SA were observed in Chinese adolescents, and there were no significant gender differences in the associations. Moreover, these associations were partially mediated through sleep quality. Targeted interventions for adolescents’ NSSI and SA should focus on those who have depressive and anxiety symptoms, and poor sleep quality.

The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents: a cohort study in China

“…This study used data from the Chinese Adolescent Health Growth Cohort (CAHGC) study (register number: CCC2022061901, http://chinacohort.bjmu.edu.cn ), which aimed to investigate the development trajectory and influencing factors of risk behaviors (mainly on NSSI and aggression) among adolescents. The design, procedure, and implementation were described elsewhere [ 24 ]. In brief, using a cluster random sampling method, a representative sample of 1844 students at grade 7 from 11 middle schools across three areas (Qidong County in Hunan Province, Guangming District in Shenzhen City, Zhongshan City in Guangdong Province) were enrolled to participate in the baseline survey (T1).…”

Association between life events, anxiety, depression and non-suicidal self-injury behavior in Chinese psychiatric adolescent inpatients: a cross-sectional study

“…The degree of health adaptation of psychiatric inpatients with NSSI behavior is higher than that of non-NSSI group, and there is obvious health maladjustment. In addition, one factor that has to be considered is the occurrence of NSSI may be more common during and after COVID-19 pandemic due to COVID-19 related social distance and school lockdown policies, and isolation ( 30 ).…”

“…The related factors of adolescents NSSI are complex, many risk factors for NSSI have been proposed ( 17 , 18 , 24 ), especially negative life events, depression, anxiety, and other emotional symptoms ( 25–27 ). Symptoms of depression and anxiety serve as negative indicators of mental health, which is an important problem especially during adolescence where incidence rates are high ( 28 ), which has become an important influence factor of NSSI ( 29 , 30 ). Negative life events refer to events that an individual feels unpleasant.…”

The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents: a cohort study in China

“…This study used data from the Chinese Adolescent Health Growth Cohort (CAHGC) (register number: CCC2022061901, http://chinacohort.bjmu.edu.cn ). The design, procedure, and implementation are described elsewhere [24]. In brief, using a cluster random sampling method, a representative sample of 1844 students at grade 7 from 11 middle schools across three areas (Qidong County in Hunan Province, Guangming District in Shenzhen City, Zhongshan City in Guangdong Province) were enrolled to participate in the baseline survey (T1).…”