Inflammatory markers in adolescents with suicide attitude and self-injury behavior and their relationship with clinical findings

Aim: The aim of this study was to evaluate the clinical characteristics of adolescents aged 12-18 years who referred to Child and Adolescent Psychiatry Outpatient Clinic, who were diagnosed with NSSI and who had SA, to examine their peripheral inflammatory markers and to compare with a healthy control group. Method: Adolescents who were included in the study between September 2018 and June 2019 underwent a clinical interview in accordance with the K-SADS-PL, a semi-structured interview schedule, by the researcher and the presence of psychopathology was determined. 38 adolescents with a diagnosis of NSSI, 38 adolescents with SA and 48 healthy and volunteering age and gender matched adolescents as the control group were included and they were administered SDVF, BDÖ, BAÖ, BUÖ, BIÖ-11, SÖTÖ, ÇOYÖ, KZVD-DE, CİŞDÖ, ERA. In addition, hemogram, hsCRP, IL-6, TNF-α parameters were measured from blood samples of all adolescents. Results: The NSSI, SA and control groups were similar in terms of age, gender, smoking, BMI, and family sociodemographic characteristics. NSSI and SA groups were similar in terms of psychiatric diagnosis. When the groups were compared according to their clinical characteristics, it was found that depression, anxiety, hopelessness, impulsivity and sexual abuse scores were significantly higher in the NSSI and SA group than in the control group. When the groups were compared according to the inflammatory parameters, NLR and TNF-α values were significantly higher in the NSSI and SA group than in the control group, whereas IL-6 values were significantly higher in the NSSI and control group. When the relationship between clinical features and inflammatory parameters which were found to be significantly different between groups was evaluated, it was found that NLR and IL-6 correlated with sexual abuse and depression scores, while TNF-α correlated with anxiety, depression, hopelessness, impulsivity, anger and abuse scores. When inflammatory parameters were evaluated separately in depressive and non-depressive groups, NLO and TNF-α groups were found to be similar, whereas IL-6 levels were significantly higher in depressive and non-depressive groups in the IG group. Conclusion: The result that NLR is correlated with depression and sexual abuse scores in NSSI and SA suggests that NLR can have intermediary role in NSSI and SA increasing the effect of sexual abuse and depression; only SA group having increased IL-6 and being correlated with sexual abuse and depression scores similar to NLR suggest that IL-6 can play a role in a specific intermediary path for SA. The fact that IL-6 levels remain significantly higher in the IG group in depressive and non-depressive patients suggests that IL-6 may be a specific marker of SA.