Association between subthreshold depression and psychotic-like experiences with non-suicidal self-irjury among adoles-cents in Shandong Province
Objective To investigate the association between subthreshold depression,psychotic-like experiences(PLEs),and their interactions with non-suicidal self-injury(NSSI)in adolescents from Shandong,so as to provide a reference for the prevention and early intervention of NSSI in adolescents.Methods A random cluster sampling method was used to select a total of 6 090 ado-lescents aged 13-22 from two cities along the coast and inland of Shandong Province.Electronic surveys were administered using the Self-Injurious Behavior Questionnaire,Community Assessment of Psychic Experience-positive 8 items(CAPE-P8),and the Center for Epidemiological Studies Depression Scale(CES-D).The relationship between subthreshold depression,PLEs,and their interac-tion with NSSI was analyzed using multivariate Logistic regression.Results The detection rate of NSSI among adolescents was 21.3％.The highest NSSI reporting rate(27.9％)was found in the age group of 13-15 years.The NSSI reporting rates for those de-tected with subthreshold depression and PLEs were 49.9％and 30.7％,respectively.Multivariate analysis indicated that individuals with subthreshold depression were 3.47 times more likely to engage in NSSI[OR(95％CI)=3.47(2.68-4.50)].Those identified with PLEs had 5.32 times higher risk of engaging in NSSI than those without such experiences[OR(95％CI)=5.32(4.10-6.89)].When both subthreshold depression and PLEs coexist,the risk of engaging in NSSI was 18.47 times higher than in individuals with neither condition[OR(95％CI)=18.47(14.75-23.13)](P＜0.01).The relative excess risk due to interaction(RERI),attributable proportion(AP),and synergy index(S)were 11.44,0.61,and 2.89,respectively,indicating that the combined interaction of sub-threshold depression and PLEs accounted for 61％of adolescent NSSI.Conclusions Subthreshold depression and psychotic-like experiences are associated NSSI in adolescents and exhibit an additive interaction.Alleviating subthreshold depression in adolescents and reducing psychotic experiences may play a positive role in preventing the occurrence of NSSI.
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