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Jantarapakdee R, Uthis P, Upasen R. Risk Factors of Depression Among Adolescents With Non-suicidal Self-injury: A Systematic Review. JCCNC 2025; 11 (4) :283-296
URL: http://jccnc.iums.ac.ir/article-1-751-en.html

Background: Non-suicidal self-injury (NSSI) has gained increasing recognition in recent years as a common mental health concern among adolescents, often co-occurring with symptoms of depression. So, depressed adolescents with NSSI are significantly more likely to report higher levels of suicidal ideation and attempts and to exhibit suicidal behavior over time. Although NSSI has multiple risk factors, depression may act as a mediator that exacerbates or prolongs NSSI behaviors. This review aims to find the risk factors for depression among adolescents with NSSI.
Methods: This review followed the PRISMA (the preferred reporting items for systematic reviews and meta-analyses) guidelines. Searching was conducted across four databases: PubMed, CINAHL, ScienceDirect, and Scopus between 2014 and 2024. The risk of bias and methodological quality of the included studies were assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Each study was evaluated independently by two reviewers, and disagreements were resolved through discussion or consultation with a third reviewer. All relevant studies were managed using EndNote software, 21. A narrative synthesis was conducted to identify risk factors of depression. The protocol was registered with PROSPERO (the international prospective register of systematic reviews) (Code: CRD42024555723).
Results: Out of 2457 records yielded from the systematic search, 19 articles were selected to be included in the review, all of which were cross-sectional studies. The identified risk factors for depression were categorized into three main domains: 1) biological factors (including gender, alcohol use behavior, and exposure to negative life events), 2) psychological factors (including mental health conditions, self-directed behaviors, and cognitive functions), and 3) sociological factors (including education level of junior high school or below, parental relationships, experiences of abuse/trauma, and school bullying).
Conclusion: Several risk factors for depression in adolescents with NSSI were identified. In future studies, data from this study can be used to identify risk factors and develop interventions that reduce risk factors leading to depression in NSSI.