Potential usefulness of complete blood count parameters and inflammatory ratios as simple biomarkers of depression and suicide risk in drug-naive, adolescents with major depressive disorder

Puangsri, Pavarud; Ninla-aesong, Putrada

doi:10.1016/j.psychres.2021.114216

Cited by 17 publications

(21 citation statements)

References 46 publications

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“…Moreover, several studies have suggested that NLR was positively associated with severity of depression and might be a peripheral marker for suicidal vulnerability and behavior in depressed patients ( 42 , 43 , 103 ). Additional studies also pointed out that PLR seemed to be more predictive in evaluating the prognosis of major depression ( 44 ) and MLR was positively correlated with suicidal attempts in adolescents with depression ( 105 ).…”

Section: Introductionmentioning

confidence: 99%

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

Cheng

Wang

et al. 2022

Front. Psychiatry

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BackgroundResearch on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in depression is still emerging and has increased 3-fold since the first meta-analysis. An updated meta-analysis with sufficient studies can provide more evidence for a potential relationship between NLR, PLR, MLR, and depression.MethodsWe identified 18 studies from the PubMed, EMBASE, Cochrane library, and Web of Science databases. Meta-analyses were performed to generate pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs) between patients with depression and controls. Sensitivity analysis, subgroup analysis, meta-regression, and publication bias were conducted.ResultsA total of 18 studies including 2,264 depressed patients and 2,415 controls were included. Depressed patients had significantly higher NLR and PLR compared with controls (SMD = 0.33, 95% CI: 0.15–0.52, p < 0.001 and SMD = 0.24, 95% CI: 0.02–0.46, p < 0.05, respectively). MLR was slightly higher in depressed individuals compared to controls (SMD = 0.15, 95% CI: −0.26 to 0.55, p > 0.05), despite the absence of significance. Sensitivity analysis removing one study responsible for heterogeneity showed a higher and significant effect (SMD = 0.32, 95% CI: 0.20–0.44) of MLR. Three subgroup analyses of NLR, PLR, MLR, and depression revealed obvious differences in the inflammatory ratios between depressed patients and controls in China and the matched age and gender subgroup. Individuals with post-stroke depression (PSD) had higher NLR and MLR values as compared to non-PSD patients (SMD = 0.51, 95% CI: 0.36–0.67, p < 0.001 and SMD = 0.46, 95% CI: 0.12–0.79, p < 0.01, respectively). Meta-regression analyses showed that male proportion in the case group influenced the heterogeneity among studies that measured NLR values (p < 0.05).ConclusionsHigher inflammatory ratios, especially NLR, were significantly associated with an increased risk of depression. In the subgroup of China and matched age and gender, NLR, PLR, and MLR were all elevated in depressed patients vs. controls. Individuals with PSD had higher NLR and MLR values as compared to non-PSD patients. Gender differences may have an effect on NLR values in patients with depression.

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Section: Introductionmentioning

confidence: 99%

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

Cheng

Wang

et al. 2022

Front. Psychiatry

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“…Studies [ 39 , 40 ] have used psychological anatomy to study the association between community environment and suicide behavior, and they have found that there is a statistically significant difference between alcoholism in the case group and the control group, and the prevalence of alcoholism among suicide deaths is higher than that in the control group. In addition, many studies [ 26 , 41 ] have shown that alcoholics have a higher risk of suicide, and dangerous drinking is an independent risk factor for suicide. People with depression may seek comfort by drinking alcohol.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder: Implication for nursing care

Xu¹,

Sun²

2022

Medicine

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The incidence of suicide in patients with depressive order is much higher than other population. We aimed to evaluate the current status and risk of suicidal attempt in patients with the melancholic subtype of depressive disorder, to provide evidence for the clinical management and nursing care of depressive disorder. Patients diagnosed as the melancholic subtype of depressive disorder and treated in our hospital from June 1, 2018 to August 31, 2021 were included. The characteristics of included patients were collected and analyzed. Pearson correlation analysis and logistic regression analysis with odd ratio and 95% confidence interval were conducted to analyze the influencing factors of suicidal attempt in patients with the melancholic subtype of depressive disorder. A total of 446 patients with melancholic subtype of depressive disorder were included, the incidence of suicidal attempt was 18.83%. Pearson correlation analysis indicated that gender ( R = 0.611), alcohol drinking ( R = 0.719), living situation ( R = 0.812), number of previous admission to hospital ( R = 0.547), sleep disorder ( R = 0.612) and frequent depressive episodes ( R = 0.559) were all correlated with the suicidal attempt in patients with melancholic subtype of depressive disorder (all P < 0.05). Logistic regression analysis showed that female (OR 3.115, 95%CI 2.493–3.906), alcohol drinking(OR 1.946, 95%CI 1.684–2.763), living alone (OR 2.401, 95%CI 1.915–3.008), number of previous admission to hospital ≥ 3 (OR 2.342, 95%CI 1.601–2.742), sleep disorder (OR 1.821, 95%CI 1.328–2.215) and frequent depressive episodes (OR 3.128, 95%CI 2.421–3.779) were the independent risk factors of suicidal attempt (all P < 0.05). Suicidal attempt is common in the patients with melancholic subtype of depressive disorder, and there are many related risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder.

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“…Microglia monitors the functional state of synapses and modulates neuroplasticity by synaptic pruning and phagocytosis, resulting in altered brain structure and function, including regions implicated in impulse control and emotion regulation, such as the medial prefrontal cortex, dorsolateral prefrontal cortex, insula, amygdala, and hippocampus [7,[26][27][28]. A previous study found that elevated monocyte count and MLR are associated with an increased risk of suicide in adolescents with major depressive disorder [19]. In sum, the elevated monocyte and MLR found in this study may play an important role in the pathology of NSSI through the release of monocyte-related cytokines and activation of microglia.…”

Section: Mlrmentioning

confidence: 99%

“…Moreover, Arafat et al revealed that the levels of CRP and NLR were signi cantly elevated in individuals who committed non-fatal hanging [18]. Puangsri et al found that depressed adolescents with SA show elevated levels of MLR than those with no suicide ideation; and that the levels of MLR and NLR are positively correlated with suicidality severity [19].…”

Section: Introductionmentioning

confidence: 99%

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Elevated levels of Monocyte-lymphocyte Ratio and Platelet-lymphocyte Ratio in adolescents with Non-suicidal Self-injury

Zheng

Liu

et al. 2022

Preprint

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Background:Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) are blood indicators of systemic inflammation. This study aims to compare the levels of inflammatory indicators derived from blood routine tests between adolescents with non-suicidal self-injury (NSSI) and those with non-NSSI.Methods：A total of 201 adolescents with mood or emotional disorders were enrolled in this study, among which 106 had engaged in NSSI and 95 had never engaged in NSSI. NLR, MLR, and PLR were calculated based on the complete blood cell count. Results：There was no significant difference in demographic data between the two groups. The NSSI group exhibited significantly higher MLR (P < 0.001) and PLR (P = 0.001) than the non-NSSI group. Multivariate logistic regression analysis revealed that MLR (OR 1.545, 95%CI [1.087-2.281], P = 0.021) and PLR (OR 1.327, 95%CI [1.215-1.450], P < 0.001) were independent predictors of NSSI. Receiver operating characteristic (ROC) curve analyses demonstrated that for predicting NSSI, the optimal cut-off value of MLR was 0.135 and the area under curve was 0.638 ([0.561- 0.715], P < 0.001), with a sensitivity of 90.60% and a specificity of 33.70%; the optimal cut-off value of PLR was 127.505 and the area under curve was of 0.611 ([0.533-0.689], P < 0.001), with a sensitivity of 39.60% and a specificity of 81.10%.Conclusions:Systemic inflammation, as indicated by MLR and PLR, is elevated in adolescents with NSSI. MLR and PLR might serve as potential biomarkers in the assessment of NSSI in adolescents.

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Potential usefulness of complete blood count parameters and inflammatory ratios as simple biomarkers of depression and suicide risk in drug-naive, adolescents with major depressive disorder

Cited by 17 publications

References 46 publications

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

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

Risk factors for suicidal attempt in patients with the melancholic subtype of depressive disorder: Implication for nursing care

Elevated levels of Monocyte-lymphocyte Ratio and Platelet-lymphocyte Ratio in adolescents with Non-suicidal Self-injury

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