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
Abstract
We determined whether an elevated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were associated with depression in major depressive disorder (MDD), or suicide risk in MDD patients. A total of 137 adolescents with MDD who were antidepressant-naïve and 56 healthy controls (HC) were included. Recent suicidal behaviors were assessed. The NLR, PLR, and MLR were calculated from parameters obtained from a routine complete blood cell count parameters and compared between the MDD subgroups and HC. Cohen's d was calculated as a measure of effect size. The linear relationship between biomarkers with depression severity or suicidality severity was also analysed. Changes in CBC parameters and inflammatory ratios appeared to be more closely related to the suicidality severity than depressive severity. As compared with HC, the WBC count, neutrophil percentage, platelet count, NLR, and PLR were higher in MDD, whereas the lymphocyte percentage was lower. As compared to non-suicidal ideation (non-SI) MDD and HC, the lymphocyte percentage was decreased in MDD with suicidal attempts (SA), whereas monocyte count and MLR were increased. Suicidal attempts in MDD patients were associated with the lower lymphocytes percentage, as well as the elevated monocyte count and MLR.
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In Puangsri and Ninla-Aesong, MLR tended to be higher in the major depressive disorder with suicidal ideation group.
“MLR tended to be higher in the MDD SI group”
In three studies, NLR was higher in depressed patients with a history of SA vs HC.
“In three studies, NLR was reported to be higher in depressed patients with a history of SA vs HC [9, 20, 30].”
MLR was reported to be higher in depressed patients with SA vs HC.
“MLR was reported to be higher in depressed patients with SA vs HC [9].”
MLR was positively correlated with suicidal attempts in adolescents with depression.
“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).”
From Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis (2022) · cites this paper as [105]
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Puangsri, P., Jinanarong, V., & Ninla-aesong, P. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.11.017 · Cited by 24 · see citing works
Self-citation
- Authors
- Puangsri, P., & Ninla-aesong, P.
- Affiliations
- Walailak University (TH)
- ORCID
- Puangsri, Pavarud
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2021-11
- Volume
- 305
- Pages
- 114216
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W3200464930
- Cited by
- 62
- References
- 22
- Citations by year
- 2026: 9 · 2025: 23 · 2024: 13 · 2023: 9 · 2022: 8
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Walailak University
- Topics
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- major depressive disorder, adolescents, suicide risk, suicidal ideation, suicide attempts, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, inflammatory markers, complete blood count, drug-naive patients, depression severity
- MeSH terms
- Adolescent, Blood Cell Count, Blood Platelets, Depression, Depressive Disorder, Major, Major Depressive Disorder, Humans, Lymphocytes, Monocytes, Neutrophils, Retrospective Studies, Biomarkers, Suicidal Ideation
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