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World J Psychiatry. Sep 19, 2026; 16(9): 118371
Published online Sep 19, 2026. doi: 10.5498/wjp.118371
Published online Sep 19, 2026. doi: 10.5498/wjp.118371
Combined transcranial direct current and repetitive transcranial magnetic stimulation for adolescent non-suicidal self-injury
Huan-Zhen Liu, Wan-Gen Liu, Hou-Qiang Fu, Chang Liu, Cheng-Xi Li, Clinical Psychological Clinic, Cangzhou Central Hospital, Cangzhou 061000, Hebei Province, China
Hao Lv, Outpatient Clinic, Cangzhou Boshi Youmian Comprehensive Outpatient Clinic, Cangzhou 061000, Hebei Province, China
Author contributions: Liu HZ designed the study, performed statistical analysis, and drafted the manuscript; Liu WG contributed to study design and critically revised the manuscript; Fu HQ and Liu C participated in data collection and neuromodulation treatments; Lv H was responsible for patient screening and clinical evaluations; Li CX assisted with statistical analysis and figure preparation. All authors approved the final manuscript.
AI contribution statement: No AI tools were used at any stage of manuscript preparation. The authors assume full responsibility for the integrity and scientific validity of this work.
Supported by Hebei Province Medical Science Research Project Plan, No. 20261305.
Institutional review board statement: The study protocol was reviewed and approved by the Medical Ethics Committee of Cangzhou Central Hospital, ethics approval No. 2025-143-01(z).
Informed consent statement: Due to the retrospective study, informed consent was waived by the Ethics Committee of Cangzhou Central Hospital. All patient data were anonymized prior to analysis, and no identifiable personal information was accessed or reported.
Conflict-of-interest statement: All authors declare that they have no conflict of interest related to this study.
Data sharing statement: No additional data are available.
Corresponding author: Huan-Zhen Liu, MD, Chief Physician, Clinical Psychological Clinic, Cangzhou Central Hospital, No. 16 Xinhua West Road, Yunhe District, Cangzhou 061000, Hebei Province, China. zhaoqi912@126.com
Received: January 16, 2026
Revised: February 10, 2026
Accepted: June 26, 2026
Published online: September 19, 2026
Processing time: 219 Days and 21.9 Hours
Revised: February 10, 2026
Accepted: June 26, 2026
Published online: September 19, 2026
Processing time: 219 Days and 21.9 Hours
Core Tip
Core Tip: Non-suicidal self-injury in adolescents remains difficult to treat, and evidence for neuromodulation is limited. This retrospective study demonstrates that combined transcranial direct current stimulation and repetitive transcranial magnetic stimulation (rTMS) is associated with greater improvement in self-injury behaviors, emotional regulation, impulsivity, and affective symptoms compared with rTMS alone or psychotherapy. Moreover, baseline emotion regulation difficulty, illness duration, comorbid depression, and childhood trauma history were identified as important factors influencing treatment response, providing clinically relevant guidance for individualized intervention strategies.