Abstract: Objective: To explore the influence of family, interpersonal relationships and childhood trauma on non-suicidal self-injury (NSSI) in adolescents with first-episode depression.Methods: A total of 110 adolescent patients with first-episode depression were enrolled.According to DSM-5, the patients were divided into a group with NSSI (n=57) and a group without NSSI (n=53).Self-Dating Depression Scale (SDS), Self-Dating Anxiety Scale (SAS), Comprehensive Diagnostic Scale for Interpersonal Relationships and Childhood Trauma Question-naire were used to evaluate the emotional, interpersonal and other psychological symptoms of patients.Pearson correlation analysis was used to analyze the relationship between interpersonal relationships, childhood trauma, anxiety and depression.Binary logistic regression was used to analyze the independent risk factors of NSSI.Me-diation effects were evaluated through Bootstrap method.Results: There were statistically signifi-cant differences in gender, parental affection, and re-lationships with parents and classmates between the two groups (all P< 0.05).In the group with NSSI, scores for the three factors of conversation, communication, and interpersonal relationships, as well as the total score, and scores for emotional abuse, sexual abuse, emotional neglect, and physical neglect, as well as SAS and SDS scores, were higher than those in the group without NSSI(all P< 0.05).Pearson correlation analysis showed that in the group with NSSI, talking dimension was positively correlated with emotional abuse, emotional and physical neglect(r=0.345, 0.273, and 0.297, respectively, all P< 0.05), and emotional abuse was positively corre-lated with SDS score and SAS score (r=0.302, 0.290, respectively, all P< 0.05).Logistic regression analysis showed that relationship with parents, communication dimension, and sexual abuse were independent risk factors for NSSI.There were mediating effects between depression and NSSI in communication.Conclusion: Adoles-cent depression patients with NSSI may experience more childhood trauma and poor family interpersonal relation-ships, and are less adept at handling interpersonal and emotional issues.Depression plays an indirect role in the relationship between interpersonal communication and NSSI, serving as a mediating moderator.