Abstract
ObjectivesBehavioral disturbances in adolescence are potentially linked to aberrant functioning of the thyroid gland. Accordingly, alterations of the hypothalamic-pituitary-thyroid (HPT) axis might impact psychopathological development. Yet corresponding research in adolescents with nonsuicidal self-injury (NSSI) and comorbid mental disorders is scarce. MethodsThe present study examined HPT axis functioning in adolescents with NSSI compared to healthy controls (HC) using blood-based assays of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and the ratio of these hormones (fT3/fT4 ratio). Cortisol was additionally examined to contrast HPT axis functioning with a well-established biomarker of stress responsivity. Moreover, associations between clinical characteristics, HPT axis and HPA axis functioning were investigated. Female adolescents meeting NSSI criteria according to DSM-5 criteria (n = 117) were compared to adolescent HC (n = 41). Standardized serum-based endocrinological assays and interview- and questionnaire-based psychiatric assessments were used. Smoking status was included as covariate for all analyses. ResultsNSSI patients displayed altered HPT axis functioning as fT3/fT4 ratio values were blunted in comparison to HC. Negative correlations were further present between fT3, fT3/fT4 ratio and severity of BPD symptoms, depression scores and symptomatic distress. TSH correlated negatively with severity of BPD symptoms and symptomatic distress exclusively. Cortisol values differed neither significantly between experimental groups nor correlated significantly with clinical characteristics. ConclusionsLongitudinal examinations, assessing links between psychopathology and endocrinological alterations, are warranted to address potential clinical implications of thyroid markers in child and adolescent psychiatry.
Highlights
Nonsuicidal self-injury (NSSI) is a serious and common phenomenon in adolescence
Groups did not differ on age, body weight, body height, body mass index (BMI), average physical activity per week, estradiol levels, menstrual status, hormonal contraceptive use, medical condition within the past 3 months, alcohol consumption, or illicit drug use
The current study examined HPT axis hormones in adolescents with nonsuicidal self-injury (NSSI) compared to healthy controls
Summary
Nonsuicidal self-injury (NSSI) is a serious and common phenomenon in adolescence. NSSI has been introduced as a disorder warranting further research in the 5th version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American PsychiatricAssociation, 2013). Nonsuicidal self-injury (NSSI) is a serious and common phenomenon in adolescence. Epidemiological research estimated that single events of NSSI occur in 17% of adolescent nonclinical samples while 5% even meet criteria for NSSI disorder (NSSID) (Swannell et al, 2014). NSSI is often accompanied by comorbid disorders such as borderline personality disorder (BPD) or major depressive disorder (MDD) (Ghinea et al, 2020). Both disorders emerge commonly during adolescence and include severe emotion dysregulation. Research shows that NSSI, BPD and depression are common phenomena in adolescence, yet biological markers potentially underlying these psychopathologies have been investigated insufficiently
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