bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2026-1-1163bekhterev-1316Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWБиологические основы несуицидального самоповреждающего поведения в подростковом возрасте: нарративный обзорBiological Underpinnings of Non-Suicidal Self-Injury in Adolescence: A Narrative Reviewhttps://orcid.org/0000-0002-7905-4583ПоповМ. Ю.PopovM. Yu.

Попов Михаил Юрьевич — д.м.н., главный научный сотрудник, руководитель отделения терапии психических расстройств у лиц молодого возраста 

192019, Санкт-Петербург, ул. Бехтерева, д. 3

Saint Petersburg

popovmikhail@mail.ruhttps://orcid.org/0000-0001-9516-4427ЛепикО. В.LepikO. V.

Лепик Ольга Витальевна — младший научный сотрудник отделения терапии психических расстройств у лиц молодого возраста

192019, Санкт-Петербург, ул. Бехтерева, д. 3

Saint Petersburg

ovlepik@gmail.comНациональный медицинский исследовательский центр психиатрии и неврологии им. В.М. БехтереваРоссияV.M. Bekhterev National Medical Research Centre for Psychiatry and NeurologyRussian Federation2026020320266012235Copyright © Попов М.Ю., Лепик О.В., 20262026Попов М.Ю., Лепик О.В.Popov M.Y., Lepik O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/1316Обоснование

Обоснование. Несуицидальные самоповреждения — значимая проблема психического здоровья подростков и фактор риска суицида. Понимание биологических основ самоповреждающего поведения важно для разработки эффективных диагностических и терапевтических стратегий.

Цель

Цель: обобщить и критически проанализировать современные научные данные о биологических механизмах несуицидальных самоповреждений у подростков.

Методы

Методы. Проведен нарративный обзор (поиск в базах данных: MEDLINE, Web of Science, eLIBRARY.RU, КиберЛенинка). В обзор включали исследования биологических аспектов несуицидальных самоповреждений в подростковых выборках. Результаты отобранных исследований структурировали по биологическим системам, данные обобщали c учетом взаимодействия отдельных дисфункций в динамике развития самоповреждающего поведения.

Результаты

Результаты. Обзор выявил мультисистемные нарушения при несуицидальном самоповреждающем поведении: структурные и функциональные изменения мозга (особенно в префронтальной коре, соматосенсорных областях, сети пассивного режима работы мозга); дисфункцию нейрохимических систем (дефицит эндогенных опиоидов, изменения эндоканнабиноидов); дисрегуляцию гипоталамо-гипофизарно-надпочечниковой оси и вегетативной нервной системы (гипореактивность на психосоциальный стресс, гиперреактивность на боль); активацию иммуновоспалительных механизмов; снижение болевой чувствительности; генетические (умеренная наследуемость, полиморфизмы генов серотонинергической системы) и эпигенетические факторы (гиперметилирование гена POMC). Обсуждены взаимодействия между отдельными биологическими факторами в рамках временнóй модели (дистальные предикторы, проксимальные корреляты, непосредственные маркеры эпизода).

Заключение

Заключение. Несуицидальное самоповреждающее поведение подростков характеризуется мультисистемными биологическими нарушениями, формирующимися под влиянием генетической предрасположенности и среды. Полученные данные, несмотря на неоднородность, углубляют понимание механизмов развития и поддержания самоповреждающего поведения и открывают перспективы для разработки биомаркеров риска и биологически обоснованных, персонализированных подходов к терапии. Для преодоления методологических ограничений необходимы лонгитюдные исследования с интегративной оценкой биологических и психосоциальных факторов.

Non-suicidal self-injury is a significant adolescent mental health problem and a risk factor for suicide. Understanding the biological mechanisms of self-injurious behavior is crucial for developing effective diagnostic and therapeutic strategies.

Aim

Aim: To summarize and critically analyze contemporary scientific data on the biology of non-suicidal self-injury in adolescents.

Methods

Methods. A narrative review was conducted (databases searched: MEDLINE, Web of Science, eLIBRARY.RU, CyberLeninka). Studies investigating biological aspects of non-suicidal self-injury in adolescent samples were included. Findings from selected studies were structured according to biological systems, and data were synthesized with regards to the interplay between these systems within the developmental trajectory of self-injurious behavior.

Results

Results. The review revealed multisystem impairments in non-suicidal self-injury: structural and functional brain changes (particularly in the prefrontal cortex, somatosensory areas, and default mode network); dysfunction of neurochemical systems (deficit in endogenous opioids, alterations in endocannabinoids); dysregulation of both hypothalamic-pituitary-adrenal axis and autonomic nervous system (hyporeactivity to psychosocial stress, hyperreactivity to pain); activation of immune-inflammatory mechanisms; reduced pain sensitivity; and genetic (moderate heritability, serotonin-related gene polymorphisms) and epigenetic factors (hypermethylation of POMC). Complex interplay between biological factors within a temporal framework (distal predictors, proximal correlates, immediate episode-related factors) is discussed.

Conclusion

Conclusion. Non-suicidal self-injurious behavior in adolescents is characterized by multisystem biological dysfunctions shaped by genetic predisposition and environmental factors. Despite data heterogeneity, the findings deepen our understanding of the mechanisms underlying the development and progression of non-suicidal self-injury and open prospects for developing risk biomarkers and biologically informed, personalized therapeutic approaches. Longitudinal studies integrating the assessment of biological and psychosocial factors are necessary to overcome current methodological limitations.

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The authors declare that there are no conflicts of interest present.