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抑郁障碍合并非自杀性自伤（NSSI）是青少年精神科十分常见的共病类型，两种病症相互加重，不仅破坏患者社会功能，还会大幅提升自杀风险，也是青少年心理健康防控工作中的一大难点。国内现有研究多侧重社会、心理层面诱因，针对该共病的神经生理机制，尚且缺少系统性梳理。已有研究证明，疼痛感知异常、内啡肽系统功能失调是该病症的核心病理基础。抑郁会让青少年出现痛觉分离、β-内啡肽基础分泌不足等问题；而非自杀性自伤会促使机体代偿性分泌内啡肽，暂时缓解负面情绪与情感麻木，行为反复后便会形成顽固的不良循环。基因多态性、童年负性应激引发的表观遗传变化，还会提升患病易感性。本文汇总近年实证研究，围绕疼痛感知与内啡肽系统的交互机制展开分析，总结发病规律与干预思路，为此类病症的精细化防治工作提供理论依据。
Abstract：Depression combined with non-suicidal self-injury (NSSI) occurs frequently among teenagers， bringing great challenges to adolescent mental health management. This combined disorder will severely impair patients’ social competence and raise the risk of suicide. Most domestic researches pay attention to psychosocial risk factors， yet few conduct in-depth and systematic analysis on its neurophysiological mechanisms. As verified by existing studies， abnormal pain perception and dysfunction of the endogenous opioid system constitute the main pathological basis. Depression will cause pain dissociation and reduced basic secretion of β-endorphin in adolescents. In contrast， NSSI will stimulate compensatory release of endorphin to ease negative feelings and emotional numbness， eventually forming a fixed behavioral cycle. Genetic polymorphisms and epigenetic modifications caused by adverse experiences in childhood will make adolescents more vulnerable to this comorbidity. This article analyzes the interaction between pain perception and the endorphin system， sorts out disease progression and intervention measures， and offers references for targeted prevention and treatment.
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基本信息:
中图分类号:R749.4
引用信息:
[1]苏燕,李国琼,张炳奎,等.青少年抑郁与非自杀性自伤：疼痛感知异常与内啡肽系统的交互作用[J].中国健康心理学杂志().
基金信息:
云南省科技厅-云南省中医药大学应用基础研究联合专项基金（编号：202301AZ070001-121）
2026-07-10
2026-07-10
2026-07-10