抑郁伴NSSI青少年认知功能与血浆Hcy的关系
Relationship between Cognitive Function and Plasma Homocysteine in Depressed Adolescents with Non-Suicidal Self-Injury
DOI: 10.12677/acm.2026.1652074, PDF,    科研立项经费支持
作者: 李 佳, 瞿 娜*：华中科技大学同济医学院附属武汉精神卫生中心，湖北 武汉；武汉市精神卫生中心康复治疗部，湖北 武汉；武汉市精神卫生中心心理健康和神经科学研究中心，湖北 武汉
关键词: 认知功能；同型半胱氨酸；非自杀性自伤；青少年；Cognitive Function； Homocysteine； Non-Suicidal Self-Injury； Adolescents
摘要: 目的：探讨伴有非自杀性自伤(Non-suicidal self-injury, NSSI)行为的抑郁青少年认知功能的发生现状及其与血浆Hcy的关系，为临床早期发现和干预提供思路。方法：纳入2025年1月至2025年9月在武汉市精神卫生中心收治的116例伴有NSSI的青少年抑郁患者作为研究对象。通过蒙特利尔认知评估量表(MoCA)评估患者认知功能，自残功能评估量表(FASM)了解患者NSSI行为的发生情况，汉密尔顿抑郁量表24项(HAMD-24)评估患者抑郁程度，测量患者血浆Hcy水平。使用二元Logistic回归模型和Spearman相关分析探讨认知功能的影响因素。结果：本研究共纳入116例青少年抑郁伴NSSI患者，平均年龄为(15.81 ± 3.05)岁，平均BMI为(20.67 ± 3.63) kg/m2。根据MoCA量表得分情况分为认知功能正常组49名(占42.24%, MoCA总分平均为28.26 ± 1.25分)和认知功能损伤组67名(占57.76%，MoCA总分为21.22 ± 6.36分)。认知功能损伤组患者的Hcy水平显著高于认知功能正常组，两组间Hcy水平差异具有统计学意义(13.28 ± 4.83 vs 10.29 ± 2.60 μmol/L, P < 0.01)。认知功能损伤组HAMD总分显著高于认知功能正常组(37.61 ± 11.45 vs 32.76 ± 8.66分)，两组间差异具有统计学意义(P < 0.05)。研究结果显示：最常见的5种自残方式依次为“故意打自己”“故意割伤或划伤皮肤”“用拳头击打或用头撞硬物”“故意咬伤自己(如嘴或嘴唇等)”“故意刮伤自己的皮肤”。二元Logistic回归分析结果显示，血浆Hcy与伴有NSSI的青少年抑郁患者认知功能损伤存在显著正关联(P均 < 0.05)。相关性分析结果显示，抑郁伴有NSSI青少年的认知功能损伤与血浆Hcy、HAMD总分均呈正相关(P均 < 0.05)。结论：伴有NSSI的抑郁青少年患者中认知功能损伤的发生比例较高，血浆Hcy与伴有NSSI的青少年抑郁患者认知功能损伤呈正相关。
Abstract: Objective: To investigate the prevalence of cognitive impairment and its relationship with plasma homocysteine (Hcy) in depressed adolescents with non-suicidal self-injury (NSSI), providing insights for early clinical detection and intervention. Methods: The study consisted of 116 depressed adolescents exhibiting NSSI behaviors, who were admitted to Wuhan Mental Health Center between January 2025 and September 2025. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), NSSI behavior using the Functional Assessment of Self-Mutilation (FASM), and depression severity using the 24-item Hamilton Depression Scale (HAMD-24). Plasma homocysteine (Hcy) level was measured. Binary logistic regression and Spearman correlation analyses were performed to explore factors associated with cognitive function. Results: A total of 116 adolescents with depression and NSSI were included, with a mean age of (15.81 ± 3.05) years and a mean BMI of (20.67 ± 3.63) kg/m2. Based on MoCA score, participants were categorized into normal cognitive function group (n = 49, 42.24%; mean MoCA score: 28.26 ± 1.25) and cognitive impairment group (n = 67, 57.76%; mean MoCA score: 21.22 ± 6.36). Plasma Hcy level in the cognitive impairment group were significantly higher than that in the normal cognitive function group, with a statistically significant difference observed between the two groups (13.28 ± 4.83 vs 10.29 ± 2.60 μmol/L, P < 0.01). The total HAMD score in the cognitive impairment group was significantly higher than that in the normal cognitive function group (37.61 ± 11.45 vs. 32.76 ± 8.66), and the difference was statistically significant (P < 0.05).The results indicated that the five most common methods of NSSI were: “deliberately hitting oneself”, “deliberately cutting or scratching the skin”, “hitting with fists or banging head against hard objects”, “deliberately biting oneself (e.g., mouth or lips)”, and “deliberately scraping one’s skin”. Binary Logistic regression analysis revealed a significant positive association between plasma Hcy level and cognitive impairment in adolescents with depression and NSSI (all P < 0.05). Correlation analysis demonstrated that cognitive impairment in depressed adolescents with NSSI was positively correlated with both plasma Hcy level and total HAMD scores (all P < 0.05). Conclusion: The prevalence of cognitive impairment is relatively high among depressed adolescents with NSSI. Plasma Hcy levels are positively correlated with cognitive impairment in this population.
文章引用：李佳, 瞿娜. 抑郁伴NSSI青少年认知功能与血浆Hcy的关系[J]. 临床医学进展, 2026, 16(5): 2641-2649. https://doi.org/10.12677/acm.2026.1652074

参考文献

[1] 中国神经科学学会精神病学基础与临床分会儿童青少年精神医学联盟, 张宁, 柯晓燕, 王纯, 郑毅, 刘靖, 等. 非自杀性自伤的临床诊治的专家共识[J]. 临床精神医学杂志, 2025, 35(6): 480-484.
[2] Zeng, J.W., Zhao, J.L., Han, Z.J., Duan, Y.J. and Lin, L. (2023) Narrative Review: Pathogenesis of the Inflammatory Response and Intestinal Flora in Depression. Neuropsychiatric Disease and Treatment, 19, 2469-2483. [Google Scholar] [CrossRef] [PubMed]
[3] Vázquez López, P., Armero Pedreira, P., Martínez-Sánchez, L., García Cruz, J.M., Bonetde Luna, C., Notario Herrero, F., et al. (2023) Self-Injury and Suicidal Behavior in Children and Youth Population: Learning from the Pandemic. Anales de Pediatría (English Edition), 98, 204-212. [Google Scholar] [CrossRef] [PubMed]
[4] Wu, Y., Zhang, Y., Wang, C. and Huang, B. (2024) A Meta-Analysis on the Lifetime and Period Prevalence of Self-Injury among Adolescents with Depression. Frontiers in Public Health, 12, Article 1434958. [Google Scholar] [CrossRef] [PubMed]
[5] Ren, T., Wen, Y., Ma, L., Qiao, D., Li, G., Li, H., et al. (2025) Psychosocial Factors Affect the Occurrence of Non-Suicidal Self-Injury in Adolescents with Major Depressive Disorder through Chain Mediation. European Archives of Psychiatry and Clinical Neuroscience, 275, 1209-1220. [Google Scholar] [CrossRef] [PubMed]
[6] Su, W., Liu, H., Zhou, X. and Huang, X. (2025) Depression and Non-Suicidal Self-Injury: The Mediating Roles of Childhood Trauma and Impulsivity. Frontiers in Psychiatry, 16, Article 1580235. [Google Scholar] [CrossRef] [PubMed]
[7] Shao, C., Wang, X., Ma, Q., Zhao, Y. and Yun, X. (2021) Analysis of Risk Factors of Non-Suicidal Self-Harm Behavior in Adolescents with Depression. Annals of Palliative Medicine, 10, 9607-9613. [Google Scholar] [CrossRef] [PubMed]
[8] Himelein-Wachowiak, M., Giorgi, S., Kwarteng, A., Schriefer, D., Smitterberg, C., Yadeta, K., et al. (2022) Getting “Clean” from Nonsuicidal Self-Injury: Experiences of Addiction on the Subreddit R/Self-Harm. Journal of Behavioral Addictions, 11, 128-139. [Google Scholar] [CrossRef] [PubMed]
[9] Chen, H., Hong, L., Tong, S., Li, M., Sun, S., Xu, Y., et al. (2023) Cognitive Impairment and Factors Influencing Depression in Adolescents with Suicidal and Self-Injury Behaviors: A Cross-Sectional Study. BMC Psychiatry, 23, Article No. 247. [Google Scholar] [CrossRef] [PubMed]
[10] Zhang, Y., Lai, S., Wu, W., Wang, Y., Zhao, H., He, J., et al. (2022) Associations between Executive Function Impairment and Biochemical Abnormalities in Depressed Adolescents with Non-Suicidal Self-Injury. Journal of Affective Disorders, 298, 492-499. [Google Scholar] [CrossRef] [PubMed]
[11] Goreis, A., Pfeffer, B., Hajek Gross, C., Klinger, D., Oehlke, S.M., Zesch, H., et al. (2024) Attentional Biases and NonSuicidal Self-Injury Urges in Adolescents. JAMA Network Open, 7, e2422892. [Google Scholar] [CrossRef] [PubMed]
[12] Hu, Z., Han, Y., Hu, M., Zhang, H., Yuan, X. and Yu, H. (2024) A Comparative Study of Cognitive Function in Young Patients with Bipolar Disorder with and without Non-Suicidal Self-Injury. Acta Psychologica, 243, Article 104137. [Google Scholar] [CrossRef] [PubMed]
[13] Wen, Y., Zhang, X., Xu, Y., Qiao, D., Guo, S., Sun, N., et al. (2021) Cognitive Impairment in Adolescent Major Depressive Disorder with Non-Suicidal Self-Injury: Evidence Based on Multi-Indicator ERPs. Frontiers in Human Neuroscience, 15, Article 637407. [Google Scholar] [CrossRef] [PubMed]
[14] Sitdikova, G. and Hermann, A. (2023) Homocysteine: Biochemistry, Molecular Biology, and Role in Disease 2021. Biomolecules, 13, Article 1111. [Google Scholar] [CrossRef] [PubMed]
[15] Xu, C.C., Zhao, W.X., Sheng, Y., Yun, Y.J., et al. (2025) Serum Homocysteine Showed Potential Association with Cognition and Abnormal Gut Microbiome in Major Depressive Disorder. World Journal of Psychiatry, 15, Article 102567. [Google Scholar] [CrossRef] [PubMed]
[16] Moradi, F., Lotfi, K., Armin, M., Clark, C.C.T., Askari, G. and Rouhani, M.H. (2021) The Association between Serum Homocysteine and Depression: A Systematic Review and Meta-Analysis of Observational Studies. European Journal of Clinical Investigation, 51, e13486. [Google Scholar] [CrossRef] [PubMed]
[17] Kindler, J., Koenig, J., Lerch, S., van der Venne, P., Resch, F. and Kaess, M. (2022) Increased Immunological Markers in Female Adolescents with Non-Suicidal Self-Injury. Journal of Affective Disorders, 318, 191-195. [Google Scholar] [CrossRef] [PubMed]
[18] Zhang, C., Li, Y., Wang, W., Jiang, Z., Liu, C., Kong, Y., et al. (2024) Gender Differences of Antioxidant System and Thyroid Function in Depressed Adolescents with Non-Suicidal Self-Injury. Neuropsychiatric Disease and Treatment, 20, 1309-1319. [Google Scholar] [CrossRef] [PubMed]
[19] Asimujiang, S. and Zhang, Y. (2025) Possible Mechanisms of Homocysteine in the Pathogenesis of Depressive Disorder. Journal of Clinical Technology and Theory, 3, 51-54. [Google Scholar] [CrossRef] 
[20] Nevmerzhytska, N.M., Orzheshkovskyi, V.V., Dzevulska, I.V. and Savosko, S.I. (2019) Mechanisms of Toxic Effects of Homocysteine on the Nervous System. Neurophysiology, 51, 379-387. [Google Scholar] [CrossRef] 
[21] Han, Y., Huang, X., Du, Y. and Yao, Z. (2025) Inflammation and Impulsivity Pathways in Non-Suicidal Self-Injury among Bipolar Disorder: A 24-Week Longitudinal Cohort Study. Journal of Affective Disorders, 391, Article 120015. [Google Scholar] [CrossRef] [PubMed]
[22] Qiao, D., Qi, Y., Zhang, X., Wen, Y., Huang, Y., Li, Y., et al. (2025) The Possible Effect of Inflammation on Non-Suicidal Self-Injury in Adolescents with Depression: A Mediator of Connectivity within Corticostriatal Reward Circuitry. European Child & Adolescent Psychiatry, 34, 2871-2885. [Google Scholar] [CrossRef] [PubMed]
[23] Chen, S., Honda, T., Ohara, T., Hata, J., Hirakawa, Y., Yoshida, D., et al. (2020) Serum Homocysteine and Risk of Dementia in Japan. Journal of Neurology, Neurosurgery & Psychiatry, 91, 540-546. [Google Scholar] [CrossRef] [PubMed]
[24] Lauriola, M., D’Onofrio, G., Ciccone, F., Germano, C., Cascavilla, L., Paris, F., et al. (2021) Relationship of Homocysteine Plasma Levels with Mild Cognitive Impairment, Alzheimer’s Disease, Vascular Dementia, Psychobehavioral, and Functional Complications. Journal of Alzheimer’s Disease, 82, 235-248. [Google Scholar] [CrossRef] [PubMed]
[25] Qu, D., Wang, Y., Zhang, Z., Meng, L., Zhu, F., Zheng, T., et al. (2022) Psychometric Properties of the Chinese Version of the Functional Assessment of Self-Mutilation (FASM) in Chinese Clinical Adolescents. Frontiers in Psychiatry, 12, Article 755857. [Google Scholar] [CrossRef] [PubMed]
[26] 孔娟. 高同型半胱氨酸血症诊疗专家共识[J]. 肿瘤代谢与营养电子杂志, 2020, 7(3): 283-288.
[27] Ghinea, D., Edinger, A., Parzer, P., Koenig, J., Resch, F. and Kaess, M. (2020) Non-Suicidal Self-Injury Disorder as a Stand-Alone Diagnosis in a Consecutive Help-Seeking Sample of Adolescents. Journal of Affective Disorders, 274, 1122-1125. [Google Scholar] [CrossRef] [PubMed]
[28] Bertuccio, P., Amerio, A., Grande, E., La Vecchia, C., Costanza, A., Aguglia, A., et al. (2024) Global Trends in Youth Suicide from 1990 to 2020: An Analysis of Data from the WHO Mortality Database. eClinicalMedicine, 70, Article 102506. [Google Scholar] [CrossRef] [PubMed]
[29] Mürner-Lavanchy, I., Koenig, J., Lerch, S., van der Venne, P., Höper, S., Resch, F., et al. (2022) Neurocognitive Functioning in Adolescents with Non-Suicidal Self-Injury. Journal of Affective Disorders, 311, 55-62. [Google Scholar] [CrossRef] [PubMed]
[30] Niu, X.N., Wen, H., Sun, N., Yang, Y., Du, S.H., Xie, R., et al. (2022) Estradiol and Hyperhomocysteinemia Are Linked Predominantly through Part Renal Function Indicators. Frontiers in Endocrinology, 13, Article 817579. [Google Scholar] [CrossRef] [PubMed]
[31] Xiang, X., Palasuberniam, P. and Pare, R. (2024) The Role of Estrogen across Multiple Disease Mechanisms. Current Issues in Molecular Biology, 46, 8170-8196. [Google Scholar] [CrossRef] [PubMed]
[32] Wang, H., Liu, Z., Wang, X., Zhang, J. and Yang, J. (2025) Exploring the Levels of Homocysteine and Its Relationship with Cognitive Function in Children with Attention Deficit Hyperactivity Disorder. Frontiers in Neurology, 16, Article 1662441. [Google Scholar] [CrossRef] 
[33] Huang, Y., Zhou, S., Feng, S., Li, H., Zhang, Z., Liu, C., et al. (2025) Differential Relationships among Homocysteine Levels, Cognitive Deficits, and Low-Frequency Fluctuation in Brain Activity in Bipolar Disorder with Suicidal Ideation. BMC Psychiatry, 25, Article No. 514. [Google Scholar] [CrossRef] [PubMed]
[34] Zhang, Q., Cong, P., Tian, L., Wu, T., Huang, X., Zhang, Y., et al. (2024) Exercise Attenuates the Perioperative Neurocognitive Disorder Induced by Hyperhomocysteinemia in Mice. Brain Research Bulletin, 209, Article 110913. [Google Scholar] [CrossRef] [PubMed]
[35] Fan, N., Zhang, Q., Zhao, W., Yun, Y., Zhang, M., Wang, Y., et al. (2025) Association between Homocysteine Levels and Cognition in Late-Life Depression. Frontiers in Psychiatry, 16, Article 1599716. [Google Scholar] [CrossRef] 

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