A comparative study of complete blood count inflammatory markers in substance‐free acute psychotic disorder and substance‐induced psychosis

Abstract

Aim Recent studies showed a compare complete blood count (CBC) with its related measurements, including neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelet to lymphocyte ratio, are a simple and affordable test for inflammatory markers. The aim of this controlled study is to compare CBC inflammatory markers in substance‐induced psychosis (SIP) and substance‐free acute psychotic disorder (SF‐APD) and to evaluate whether these CBC inflammation values can be used in diagnosis. Methods This retrospective study was conducted with the data of 76 SF‐APD patients (including 60 cases of first‐episode psychosis [FEP]), 98 SIP patients (including 48 cases of FEP), and 32 controls. Results Patients with SF‐APD and SIP had higher white blood cell counts, neutrophil and monocyte counts, and MLR than controls. An increased NLR was more distinct in SF‐APD, while an increased MLR was observed in APD (both SF and SI) and FEP groups more than in the controls. A receiver operating characteristic analysis showed that the NLR could contribute to the identification of SF‐APD (52.6% sensitivity and 12.5% specificity, area under curve [AUC] = 0.704, 2.47 cutoff value) while an MLR could contribute to the identification of APD (70.1% sensitivity and 12.5% specificity, AUC = 0.842) as well as FEP (71.3% sensitivity and 12.5% specificity AUC = 0.831) with 0.26 cutoff value. Conclusions An NLR and MLR might be of interest for inflammatory processes involved in acute and first‐episode psychotic events, regardless of substance involvement.

Lymphocyte‐related ratios in methamphetamine‐induced psychotic disorder in Taiwan, comparing with patients with schizophrenia

“…The differences between the two patient groups in most parameters were less noticeable, with WBC, monocyte, MLR and PLR not differing significantly. Our findings support earlier research showing that individuals with schizophrenia 31,32 and substance-induced psychotic disorder 33 had stronger inflammatory responses than the healthy control group, as seen by enhanced WBC, neutrophil, basophil, NLR and MLR. The results demonstrated that both of the patient groups were impacted by significant inflammation.…”

“…Our results found the neutrophil count in patients with schizophrenia was higher and with lower lymphocyte count than the patients with methamphetamine‐induced psychotic disorder. This is consistent with a previous study, 33 which found higher NLR in substance‐free acute psychotic disorder and substance‐induced psychosis than controls as well as the group with substance‐free acute psychotic disorder had higher neutrophils and lower lymphocyte count than the group with substance‐induced psychosis. In addition, higher MLR in the two groups of patients was also observed in that study.…”