Systematic Review and Meta-Analysis of Mood Stabilizers in the Treatment of Adolescent Patients With Nonsuicidal Self-Injury in China.

Abstract

Objective: Nonsuicidal self-injury (NSSI) refers to deliberate, repeated acts of damaging one's own body tissue without suicidal intent. The aim of this systematic review and meta-analysis was to explore the effectiveness of mood stabilizers in treating depressive adolescent patients with NSSI in China.

Data Sources: Literature published before June 30, 2025, was included. Chinese databases searched included CBM (Chinese Biomedical Database), CNKI (China National Knowledge Infrastructure), WANFANG (Wanfang Database), and CSSCI (Chinese Social Sciences Citation Index); English databases included MEDLINE, Embase, and the Cochrane Library. Searches used the following keywords: [Bipolar disorder OR depression OR NSSI] AND [Mood stabilizer OR Lithium OR Valproate OR Carbamazepine OR Oxcarbazepine OR Lamotrigine OR Antipsychotic OR Antidepressant].

Study Selection: Chinese and English literature related to the treatment of NSSI with mood stabilizers in adolescent patients in China was searched. Editorials, comments, letters, reviews, and case reports were excluded. Randomized controlled trials conducted in China comparing mood stabilizer augmentation of basic therapy versus basic therapy alone for treating NSSI were included, and studies evaluating mood stabilizer treatment for NSSI using pre-post designs were also included. A total of 9 studies were included, 4 comparative studies by control group and 5 comparative studies of before and after treatment.

Data Extraction and Synthesis: Indices of depression, anxiety, impulsivity, self-injury severity, and treatment response were synthesized and analyzed. Mean differences or standardized mean differences and 95% confidence intervals (CIs) were used for symptom change. Odds ratios and their 95% CIs were also used for binary outcomes.

Results: Severity of anxiety, depression, impulsivity, and self-injury was significantly reduced following treatment with mood stabilizers. Compared to treatment without mood stabilizers, anxiety, depression, and self-injury were also significantly reduced, and the response rate was significantly improved in adolescents with depression and NSSI. The incidence of self-injury in these patients was significantly reduced by mood stabilizers.

Conclusion: These results demonstrate the important role of mood stabilizers in treating NSSI and suggest that mood stabilization may be more critical than mere improvement of affective symptoms.