Nesfatin-1 levels and non-suicidal self-injury in adolescents with major depressive disorder: a cross-sectional study
Non-suicidal self-injury (NSSI) is a deliberate, repetitive act resulting in tissue damage without suicidal intent and is frequently associated with depressive disorders. Nesfatin-1, an anorexigenic peptide expressed in the hypothalamus, has been implicated in stress-related psychopathologies beyond its metabolic functions. This study aimed to investigate the relationship between serum nesfatin-1 levels and non-suicidal self-injury in adolescents diagnosed with major depressive disorder (MDD). This study included 40 adolescents aged 12–18 years with MDD, 41 adolescents with MDD and comorbid NSSI, and 45 healthy controls. All participants were medication-free for at least eight weeks prior to enrollment. Psychiatric diagnoses were established using K-SADS-PL. Depressive symptom severity and self-injurious behaviors were assessed using the CDI and ISAS, respectively. Serum nesfatin-1 levels were measured using a sandwich enzyme-linked immunosorbent assay (ELISA). Serum nesfatin-1 levels differed significantly among the three groups ( p < 0.001) and were highest in the MDD+NSSI group. Both patient groups exhibited significantly higher nesfatin-1 levels than healthy controls, and the MDD+NSSI group showed significantly higher levels than the MDD group ( p = 0.010), despite comparable depressive symptom severity between the two patient groups. Serum nesfatin-1 levels were positively correlated with depressive symptom severity (Spearman’s ρ = 0.691, p < 0.001). ROC curve analyses demonstrated good discriminative ability of nesfatin-1 for distinguishing patient groups from healthy controls and fair discriminative ability for differentiating adolescents with MDD+NSSI from those with MDD alone (AUC = 0.671, 95% CI: 0.553–0.789, p = 0.008). CDI scores did not differ between the two patient groups ( p = 0.059) despite both being significantly higher than those of the control group ( p < 0.001). Serum nesfatin-1 levels were associated with both depressive symptom severity and NSSI in adolescents with MDD. Notably, nesfatin-1 levels differentiated adolescents with MDD+NSSI from those with MDD alone despite comparable depressive symptom severity between the two patient groups. These findings suggest that nesfatin-1 may be involved in neurobiological processes underlying self-injurious behavior in adolescent depression. Future longitudinal studies with larger samples are needed to further clarify the role and clinical relevance of nesfatin-1 in adolescents with depression and NSSI. Not applicable.