Neutrophil/Lymphocyte ratio in patients with major depression and the impact of electroconvulsive therapy

Abstract

Aim: An accumulation of evidence supports the role of inflammation in the etiology of depression, particularly in severe depression. In this study, we aimed to investigate the effect of electroconvulsive therapy (ECT) treatment on the rates of neutrophil/lymphocytes (N/L), platelets/lymphocyte (P/L) which are subclinical inflammatory markers in patients with moderate/severe depression who went into remission. Materials and Methods: Patients with major depression who had been admitted to hospital in the preceding 2 years with a diagnosis of major depression according to DSM 5 and who had undergone ECT were included in this study as well as a similar number of patients were included as a control group. The groups were compared with respect to the subclinical inflammatory markers N/L, P/L at baseline and after ECT. Fifty-seven patients were compared with respect to N/L, P/L ratios before and after ECT. Results: A total of 116 patients were included in the study, of whom 57 had major depression and 59 were in the control group. The N/L values were significantly higher in the pre-ECT patient group compared to the control group. The post-ECT N/L value was significantly higher compared to the control group and no difference was found between the P/L ratios. There was no significant difference between pre and post-ECT N/L, P/L values in the patient group. Discussion: This study suggests the presence of subclinical inflammation in moderate to severe major depression patients which persists after ECT. Largescale studies are needed to determine the effects of ECT on inflammation.

Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis

“…The eighteen studies ( 17 , 35 , 37 , 38 , 41 , 42 , 46 – 49 , 52 – 56 , 102 ) selected in this meta-analysis were published between 2015 and 2021, and consisted of 2,264 depression cases and 2,415 controls. As displayed in Table 1 , we summarized the main characteristics of these studies.…”

“…Seventeen studies ( 17 , 35 , 37 , 38 , 41 , 42 , 46 – 49 , 52 – 56 , 102 ) including a total of 2,220 patients with depression (800 males) and 2,256 controls (986 males) were evaluated in the meta-analysis. Depressed patients showed significantly higher NLR values compared with controls (SMD = 0.33, 95% CI: 0.15–0.52, p < 0.001) ( Figure 2A ).…”

“…Ten studies ( 17 , 35 , 37 , 41 , 42 , 48 , 49 , 54 – 56 ) evaluated PLR between 1,399 patients with depression (534 males) and 1,727 controls (811 males). The PLR values were distinctly higher in depressed patients than in controls (SMD = 0.24, 95% CI: 0.02–0.46, p < 0.05), and the forest plot is shown in Figure 3A .…”

“…However, the number of studies selected in the meta-analysis was relatively low. As the number of studies on the association between NLR, PLR, MLR, and depression is increasing, different voices have emerged ( 46 – 49 ). Therefore, an updated meta-analysis up to August 2021 was performed.…”