Elevated levels of monocyte-lymphocyte ratio and platelet-lymphocyte ratio in adolescents with non-suicidal self-injury
Open accessAbstract
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 = 0.007) 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 independently associated with NSSI. Receiver operating characteristic (ROC) curve analyses demonstrated that for differentiating NSSI from non-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 elevated MLR and PLR, was found to be strongly associated with NSSI among adolescents.
AI snapshot
Written from the paper’s full text.
TL;DR
Among 201 adolescents with mood or emotional disorders, those with non-suicidal self-injury (NSSI) had significantly higher monocyte-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) than those without NSSI. MLR and PLR were independently associated with NSSI, though their ROC discrimination was modest.
Key findings
- The NSSI group had significantly higher MLR (median 0.19 vs 0.16, p = 0.001) and PLR (median 115.66 vs 107.85, p = 0.007), as well as higher monocyte count (0.46 vs 0.42 ×10³/µL, p = 0.011) and lower lymphocyte count (2.39 vs 2.56 ×10³/µL, p = 0.043). NLR did not differ significantly (p = 0.091), nor did WBC, neutrophil count, platelet count, or MPV (all p > 0.05).
- In multivariate logistic regression, 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 independently associated with NSSI.
- ROC analysis for differentiating NSSI from non-NSSI: MLR AUC 0.638 (95% CI 0.561–0.715), cut-off 0.135, sensitivity 90.60%, specificity 33.70%; PLR AUC 0.611 (95% CI 0.533–0.689), cut-off 127.505, sensitivity 39.60%, specificity 81.10%.
Methods
- A total of 201 inpatient adolescents aged 13–18 years with mood or emotional disorders were enrolled: 106 with NSSI and 95 without NSSI. NSSI was determined by DSM-5 criteria and history of ≥1 self-injury in the past month; exclusions included current other psychiatric disorder, suicide attempt or ideation, serious physical illness/inflammatory conditions, and recent anti-inflammatory, corticosteroid, or antipyretic use.
- Fasting cubital vein blood samples were used for complete blood cell count; NLR, MLR, and PLR were calculated. Groups were compared using independent t tests or Mann–Whitney U tests, followed by multivariate logistic regression and ROC curve analysis (SPSS v26; two-tailed p < 0.05).
Limitations
- The paper states that it could not control for smoking, alcohol consumption, substance use, menstrual cycle, or BMI; did not evaluate NSSI symptom severity or other immune indicators such as CRP and interleukins; used convenience sampling from one hospital, risking selection bias; and was cross-sectional with a small sample, precluding causal inference.
- The paper also notes that MLR and PLR vary by age and sex in the Chinese population, and because the sample was mostly female and all participants were ≤18 years, the ROC cut-off values may not be suitable for males or other age groups.
- Evident from the text: the ROC AUCs for MLR (0.638) and PLR (0.611) indicate only modest discrimination, which the paper itself acknowledges.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 11 cited sources checked · 0 supported · 0 flagged
- Findingown data
For differentiating NSSI from non-NSSI, the optimal PLR cut-off was 127.505, with a sensitivity of 39.60% and a specificity of 81.10%.
“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%”
- Also stated in: § Results · plain
“The optimal cut-off value was 127.505 for PLR, with a sensitivity of 39.60% and specificity of 81.10%”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
MLR was significantly higher in adolescents with NSSI than in those without NSSI.
“The NSSI group exhibited significantly higher MLR (P = 0.001) and PLR (P = 0.007) than the non-NSSI group.”
- Also stated in: § Results · plain
“The monocyte count, MLR, and PLR were significantly higher in adolescents with NSSI than those without NSSI (p = 0.011, p = 0.001, p = 0.007, respectively).”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
PLR was significantly higher in adolescents with NSSI than in those without NSSI.
“The NSSI group exhibited significantly higher MLR (P = 0.001) and PLR (P = 0.007) than the non-NSSI group.”
- Also stated in: § Results · plain
“The monocyte count, MLR, and PLR were significantly higher in adolescents with NSSI than those without NSSI (p = 0.011, p = 0.001, p = 0.007, respectively).”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
PLR was independently associated with NSSI in multivariate logistic regression (OR 1.327, 95% CI 1.215-1.450, p < 0.001).
“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 independently associated with NSSI.”
- Also stated in: § Results · plain
“Multivariate logistic regression analysis showed 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 independently associated with NSSI (Table 3).”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
For differentiating NSSI from non-NSSI, PLR had an area under the curve of 0.611 (95% CI 0.533-0.689, p < 0.001).
“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)”
- Also stated in: § Results · plain
“the area under curve was 0.638 ([0.561- 0.715], p < 0.001) for MLR and 0.611 ([0.533–0.689], p < 0.001) for PLR”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
Monocyte count was significantly higher in adolescents with NSSI than in those without NSSI.
“The monocyte count, MLR, and PLR were significantly higher in adolescents with NSSI than those without NSSI (p = 0.011, p = 0.001, p = 0.007, respectively).”
Quote in the paperSubstantial claim - Findingown data
Lymphocyte count was significantly lower in the NSSI group than in the non-NSSI group.
“The lymphocyte count was significantly lower in the NSSI group (p = 0.043).”
Quote in the paperSubstantial claim - Findingown data
NLR did not differ significantly between adolescents with NSSI and those without NSSI.
“There were no significant differences in white blood cell count (WBC), neutrophil count, platelet count, mean platelet volume (MPV), and NLR between the two groups (all p > 0.05)”
- Also stated in: § Discussion · plain
“Inconsistent with our hypothesis, we found no changes in NLR in adolescents with NSSI.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Findingown data
For differentiating NSSI from non-NSSI, MLR had an area under the curve of 0.638 (95% CI 0.561-0.715, p < 0.001).
“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)”
- Also stated in: § Results · plain
“the area under curve was 0.638 ([0.561- 0.715], p < 0.001) for MLR”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Findingown data
MLR was independently associated with NSSI in multivariate logistic regression (OR 1.545, 95% CI 1.087-2.281, p = 0.021).
“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 independently associated with NSSI.”
- Also stated in: § Results · plain
“Multivariate logistic regression analysis showed 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 independently associated with NSSI (Table 3).”
Quote in the paperSubstantial claim - Also stated in: § Results · plain
- Interpretationreasoning
Elevated PLR may play a role in the pathophysiology of NSSI through its influence on peripheral inflammation and serotonin neurotransmission.
“Taken together, elevated PLR may play a role in the pathophysiology of NSSI through its influence on peripheral inflammation and serotonin neurotransmission.”
Quote in the paperNot a substantial claim - Interpretationown data
Systemic inflammation, as indicated by elevated MLR and PLR, is strongly associated with NSSI among adolescents.
“Systemic inflammation, as indicated by elevated MLR and PLR, was found to be strongly associated with NSSI among adolescents.”
- Also stated in: § Conclusion · boosted
“Through this study, we have found that systemic inflammation, as indicated by elevated MLR and PLR, was strongly associated with NSSI among adolescents.”
Quote in the paperSubstantial claim - Also stated in: § Conclusion · boosted
- Interpretationown data
MLR and PLR are superior to NLR in the assessment of NSSI in adolescents.
“Thus, our result may indicate that MLR and PLR are superior to NLR in the assessment of NSSI in adolescents.”
Quote in the paperSubstantial claim - Interpretationown data
Elevated MLR and PLR may have a potential role in the assessment of NSSI in clinical practice.
“The results showed significantly elevated levels of MLR and PLR in adolescents with NSSI compared with those with no NSSI, suggesting a potential role of MLR and PLR in the assessment of NSSI in clinical practice.”
Quote in the paperSubstantial claim - Interpretationreasoning
The elevated monocyte count 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.
“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.”
Quote in the paperSubstantial claim - Premisecitation
Results on the relationship between inflammation and NSSI are conflicting among different studies.
“However, results are conflicting among different studies.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [10] Kim JS, Kang E-S, Bahk YC, Jang S, Hong KS, Baek JH. Exploratory analysis of behavioral impulsivity, pro-inflammatory cytokines, and resting-state frontal EEG activity associated with non-suicidal self-injury in patients with mood disorder. Front Psych. 2020;11:124. source
Not checked in the free run.
- cites [11] Osimo EF, Cardinal RN, Jones PB, Khandaker GM. Prevalence and correlates of low-grade systemic inflammation in adult psychiatric inpatients: an electronic health record-based study. Psychoneuroendocrinology. 2018;91:226–34. source
Not checked in the free run.
- cites [12] Russell AE, Ford T, Gunnell D, Heron J, Joinson C, Moran P, et al. Investigating evidence for a causal association between inflammation and self-harm: a multivariable Mendelian Randomisation study. Brain Behav Immun. 2020;89:43–50. source
Not checked in the free run.
- Study design and conductown data
The study did not control for smoking, alcohol consumption, substance use, menstrual cycle, and body mass index, which affect inflammatory status.
“First, we were not able to control some factors affecting the inflammatory status of participants, such as smoking, alcohol consumption, substance use, menstrual cycle, and body mass index (BMI).”
Quote in the paperNot a substantial claim - Premisecitation
Only very few studies have investigated the relationship between NSSI and inflammation.
“Until very recently, only very few studies investigated the relationship between NSSI and inflammation.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [10] Kim JS, Kang E-S, Bahk YC, Jang S, Hong KS, Baek JH. Exploratory analysis of behavioral impulsivity, pro-inflammatory cytokines, and resting-state frontal EEG activity associated with non-suicidal self-injury in patients with mood disorder. Front Psych. 2020;11:124. source
Not checked in the free run.
- cites [11] Osimo EF, Cardinal RN, Jones PB, Khandaker GM. Prevalence and correlates of low-grade systemic inflammation in adult psychiatric inpatients: an electronic health record-based study. Psychoneuroendocrinology. 2018;91:226–34. source
Not checked in the free run.
- cites [12] Russell AE, Ford T, Gunnell D, Heron J, Joinson C, Moran P, et al. Investigating evidence for a causal association between inflammation and self-harm: a multivariable Mendelian Randomisation study. Brain Behav Immun. 2020;89:43–50. source
Not checked in the free run.
- Interpretationreasoning
The pathological mechanism of NSSI and suicidal behavior might be different.
“The present study suggested that elevated PLR and MLR were associated with NSSI, while some other studies reported that NLR might be a potential new peripheral biomarker of suicidal behavior [26, 56], indicating that the pathological mechanism of the two conditions might be different.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [26] Ekinci O, Ekinci A. The connections among suicidal behavior, lipid profile and low-grade inflammation in patients with major depressive disorder: a specific relationship with the neutrophil-to-lymphocyte ratio. Nord J Psychiatry. 2017;71(8):574–80. source
Not checked in the free run.
- cites [56] Velasco A, Rodriguez-Revuelta J, Olie E, Abad I, Fernandez-Pelaez A, Cazals A, et al. Neutrophil-to-lymphocyte ratio: a potential new peripheral biomarker of suicidal behavior. Eur Psychiatry. 2020;63(1): e14. source
Not checked in the free run.
- Interpretationcitation
The optimal MLR and PLR cut-off values obtained from this sample may not be suitable for males or other age groups.
“Thus, the findings of the ROC analyses should be interpreted with caution, as the optimal cut-off values obtained from our sample maybe not be suitable for males or other age groups.”
Quote in the paperSubstantial claim
- May combine two claims. 5
- Classified as probably not a substantial claim. 5
May combine two claims.
Findingown dataFor differentiating NSSI from non-NSSI, the optimal MLR cut-off was 0.135, with a sensitivity of 90.60% and a specificity of 33.70%.
“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%”
- Also stated in: § Results · plain
“The optimal cut-off value was 0.135 for MLR, with a sensitivity of 90.60% and specificity of 33.70%”
Quote in the paperSubstantial claim- Also stated in: § Results · plain
Classified as probably not a substantial claim. May combine two claims.
PremisecitationIn the Chinese population, MLR and PLR values vary with age and gender, with males exhibiting higher PLR and lower MLR than females, and with age increases, PLR decreases and MLR increases.
“a previous study showed that the MLR and PLR values vary with age and gender in the Chinese population, with males exhibiting higher PLR and lower MLR than females, and with age increases, PLR decreases and MLR increases [58].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [58] Wang J, Zhang F, Jiang F, Hu L, Chen J, Wang Y. Distribution and reference interval establishment of neutral-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in Chinese healthy adults. J Clin Lab Anal. 2021;35(9): e23935.
Not checked in the free run.
May combine two claims.
Study design and conductown dataThere were no significant differences in age, gender, family history, and diagnoses between the NSSI and non-NSSI groups.
“There was no significant difference in demographic data between the two groups.”
- Also stated in: § Results · plain
“There were no significant differences in age (p = 0.094), gender (p = 0.359), family history (p = 0.125), and diagnoses (p = 0.260) between the two groups.”
Quote in the paperNot a substantial claim- Also stated in: § Results · plain
May combine two claims.
Study design and conductreasoningThe study is cross-sectional with a small sample size, which precluded identifying any causal relationship between the inflammatory indicators and NSSI.
“Finally, the present study is a cross-sectional study with a small sample size, which precluded us from identifying any causal relationship between the inflammatory indicators and NSSI.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationNLR, MLR, and PLR are relatively stable biomarkers of systemic inflammation.
“According to previous studies, Neutrophil–Lymphocyte Ratio (NLR), Monocyte-Lymphocyte Ratio (MLR), and Platelet-Lymphocyte Ratio (PLR) are relatively stable biomarkers of systemic inflammation [13, 14].”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [13] Mazza MG, Lucchi S, Rossetti A, Clerici M. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in non-affective psychosis: a meta-analysis and systematic review. World J Biol Psychiatry. 2020;21(5):326–38. source
Not checked in the free run.
- cites [14] Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Pt A):229–36. source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductreasoningParticipants were recruited by convenience sampling from one hospital, which may bring about selection bias and decrease the representativeness of the sample.
“Fourth, the participants were recruited by convenience sampling from one hospital, which may bring about selection bias and decrease the representativeness of the sample.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe possible association between the severity of NSSI symptoms and inflammatory indicators was not evaluated.
“Second, the possible association between the severity of NSSI symptoms and inflammatory indicators was not evaluated.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenOther indicators of immune functions, such as CRP and interleukins, were not evaluated.
“Third, other indicators of immune functions, such as CRP and interleukins, were not evaluated.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
No prior studies have directly investigated the correlation between blood cell counts and NSSI.
“To our knowledge, no studies have directly investigated the correlation between blood cell counts and NSSI.”
The paper relies on this without support.
Testing NLR, MLR, and PLR is cost-effective and easy to access.
“The testing of these markers is cost-effective and easy to access, indicating its potential value for clinical application.”
The paper relies on this without support.
This is the first study to probe NLR, MLR, and PLR as hallmarks of systemic inflammation in adolescents with NSSI.
“To the best of our knowledge, this is the first study probing NLR, MLR, and PLR as hallmarks of systemic inflammation in adolescents with NSSI.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
High MLR in young people appears to be associated with self-harm when compared with young people without this behavior.
“However, despite not being related to SB, high MLR in young people appears to be associated with self-harm when compared with young people without this behavior [14].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Inclusion criterion conflicts with the non-NSSI group
MinorThe inclusion criteria require participants to have engaged in NSSI, but the study also enrolled 95 adolescents who had never engaged in NSSI. As written, those participants could not meet the stated criteria.
“The inclusion criteria were: (1) diagnosed with mood or emotional disorders according to the International Classification of Diseases 10th Revision (ICD-10), including anxiety disorders (AD), major depressive disorder (MDD), bipolar disorder (BD), and behavioral and emotional disorders with onset usually occurring in childhood and adolescence; (2) engaged in NSSI according to the DSM-5 criteria”
“106 had engaged in NSSI and 95 had never engaged in NSSI.”
Cites
Circulating Platelets as Mediators of Immunity, Inflammation, and Thrombosis
Koupenova, M., Clancy, L., Corkrey, H. A., & Freedman, J. E. (2018) · Circulation Research · doi:10.1161/circresaha.117.310795 · Cited by 997 · see citing works
Neutrophil-to-lymphocyte ratio, past, present and future perspectives
Záhorec, R. (2021) · Bratislavské lekárske listy/Bratislava medical journal · doi:10.4149/bll_2021_078 · Cited by 897 · see citing works
Calcia, M., Bonsall, D. R., Bloomfield, P. S., Selvaraj, S., Barichello, T., & Howes, O. D. (2016) · Psychopharmacology · doi:10.1007/s00213-016-4218-9 · Cited by 710 · see citing works
Lim, K.-S., Wong, C. H. J., McIntyre, R. S., Wang, J., Zhang, Z., Tran, B. X., Tan, W., Ho, C. S. H., & Ho, R. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16224581 · Cited by 617 · see citing works
Mars, B., Heron, J., Klonsky, E. D., Moran, P., O'Connor, R. C., Tilling, K., Wilkinson, P., & Gunnell, D. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30030-6 · Cited by 546 · cited 1× · see citing works
“attempts (SA) [6, 7] and that NSSI is the strongest predictor of future suicidal behavior [8].”
BackgroundNon-suicidal self-injury in adolescence
Brown, R. C., & Plener, P. L. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0767-9 · Cited by 498 · cited 1× · see citing works
“Background Non-suicidal self-injury (NSSI) is defined as the direct and deliberate damage to one’s own body for reasons not socially accepted, with no observable intention to die as a consequence of the behavior [1].”
BackgroundDialectical behavior therapy is effective for the treatment of suicidal behavior: A meta-analysis
DeCou, C. R., Comtois, K. A., & Landes, S. J. (2019) · Behavior Therapy · doi:10.1016/j.beth.2018.03.009 · Cited by 439 · see citing works
Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis
Angkananard, T., Anothaisintawee, T., McEvoy, M., Attia, J., & Thakkinstian, A. (2018) · BioMed Research International · doi:10.1155/2018/2703518 · Cited by 351 · see citing works
Serotonin in Animal Cognition and Behavior
Bacqué-Cazenave, J., Bharatiya, R., Barrière, G., Delbecque, J., Bouguiyoud, N., Giovanni, G. D., Cattaert, D., & Deurwaerdère, P. D. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21051649 · Cited by 341 · see citing works
Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: A meta-analysis
Mazza, M. G., Lucchi, S., Tringali, A. G. M., Rossetti, A., Botti, E. R., & Clerici, M. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.03.012 · Cited by 326 · see citing works
Turkmen, K., Erdur, F. M., Ozcicek, F., Ozcicek, A., Akbas, E. M., Ozbicer, A., Demirtas, L., Turk, S., & Tonbul, H. Z. (2013) · Hemodialysis International · doi:10.1111/hdi.12040 · Cited by 309 · see citing works
Impulsivity and nonsuicidal self-injury: A review and meta-analysis
Hamza, C. A., Willoughby, T., & Heffer, T. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.010 · Cited by 294 · see citing works
Microglia and monocytes in inflammatory CNS disease: integrating phenotype and function
Spiteri, A. G., Wishart, C. L., Pamphlett, R., Locatelli, G., & King, N. J. C. (2022) · Acta Neuropathologica · doi:10.1007/s00401-021-02384-2 · Cited by 216 · cited 1× · see citing works
“MLR Previous studies have found that an elevated level of monocyte count is associated with overexpression of immune genes and overproduction of monocytes/macrophage-related cytokines [31].”
BackgroundMazza, M. G., Lucchi, S., Rossetti, A., & Clerici, M. (2020) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2019.1583371 · Cited by 191 · see citing works
Duman, T. T., Aktaş, G., Tel, B. M. A., Koçak, M. Z., Erkuş, E., & Şavlı, H. (2019) · African Health Sciences · doi:10.4314/ahs.v19i1.35 · Cited by 168 · see citing works
Özdin, S., Sarisoy, G., & Böke, Ö. (2017) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2017.1340517 · Cited by 148 · see citing works
Platelets as Mediators of Neuroinflammation and Thrombosis
Rawish, E., Nording, H., Münte, T., & Langer, H. F. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.548631 · Cited by 143 · see citing works
Platelet Inflammatory Response to Stress
Cognasse, F., Laradi, S., Berthelot, P., Bourlet, T., Marotte, H., Mismetti, P., Garraud, O., & Hamzeh‐Cognasse, H. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.01478 · Cited by 132 · see citing works
Osimo, E. F., Cardinal, R. N., Jones, P. B., & Khandaker, G. M. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.02.031 · Cited by 124 · see citing works
Ekinci, O., & Ekinci, A. (2017) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2017.1363285 · Cited by 122 · see citing works
Aktaş, G., Duman, T. T., Atak, B., Kurtkulağı, Ö., Bilgin, S., Başaran, E., Demirkol, M. E., & Kösekli, M. A. (2020) · Family Medicine & Primary Care Review · doi:10.5114/fmpcr.2020.95311 · Cited by 120 · see citing works
Diabetes control could through platelet-to-lymphocyte ratio in hemograms
Tel, B. M. A., Aktaş, G., Duman, T. T., Erkuş, E., Koçak, M. Z., & Şavlı, H. (2019) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.65.1.38 · Cited by 119 · see citing works
Cheng, Y., Wang, Y., Wang, X., Jiang, Z., Zhu, L., & Fang, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.893097 · Cited by 110 · see citing works
The Modulatory Role of Serotonin on Human Impulsive Aggression
da Cunha‐Bang, S., & Knudsen, G. M. (2021) · Biological Psychiatry · doi:10.1016/j.biopsych.2021.05.016 · Cited by 106 · see citing works
Nonsuicidal Self‐Injury Is Predictive of Suicide Attempts Among Individuals with Mood Disorders
Chesin, M. S., Galfavy, H., Sonmez, C. C., Wong, A., Oquendo, M. A., Mann, J. J., & Stanley, B. (2017) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12331 · Cited by 105 · see citing works
Neutrophil-to-lymphocyte ratio: A potential new peripheral biomarker of suicidal behavior
Velasco, Á., Rodríguez-Revuelta, J., Olié, E., Abad, I., Fernández-Peláez, A., Cazals, A., Guillaume, S., de la Fuente-Tomás, L., Jiménez-Treviño, L., Gutiérrez, L., et al. (2020) · European Psychiatry · doi:10.1192/j.eurpsy.2019.20 · Cited by 100 · cited 2× · see citing works
“Previous studies have found that NLR is correlated with suicidality in major depression [26, 56].”
BackgroundResultVoss, C., Hoyer, J., Venz, J., Pieper, L., & Beesdo‐Baum, K. (2020) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13237 · Cited by 100 · see citing works
Fusar-Poli, L., Natale, A., Amerio, A., Cimpoesu, P., Grimaldi Filioli, P., Aguglia, E., Amore, M., Serafini, G., & Aguglia, A. (2021) · Brain Sciences · doi:10.3390/brainsci11010058 · Cited by 93 · see citing works
Ohmura, Y., Tsutsui‐Kimura, I., Sasamori, H., Nebuka, M., Nishitani, N., Tanaka, K. F., Yamanaka, A., & Yoshioka, M. (2019) · Neuropharmacology · doi:10.1016/j.neuropharm.2019.107703 · Cited by 92 · see citing works
Ivković, M., Pantović-Stefanović, M., Dunjić-Kostić, B., Jurišić, V., Lačković, M., Totić-Poznanović, S., Jovanović, A. A., & Damjanović, A. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.01.005 · Cited by 89 · cited 1× · see citing works
“one study also showed that NLR in patients with bipolar disorder and SA is higher than that in healthy controls [27].”
BackgroundNalbant, A., Kaya, T., Varım, C., et al. (2020) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.66.6.746 · Cited by 79 · see citing works
Özyurt, G., & Binici, N. C. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.08.007 · Cited by 74 · cited 1× · see citing works
“A study also found that adolescents with depression had higher NLR, which was positively correlated with the severity of depression [25].”
BackgroundInanli, I., Aydin, M., Çaliskan, A. M., & Eren, I. (2019) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2019.1640789 · Cited by 69 · see citing works
Adolescent mental health in China requires more attention
Wang, C., Zhang, P., & Zhang, N. (2020) · The Lancet Public Health · doi:10.1016/s2468-2667(20)30094-3 · Cited by 68 · see citing works
Role of platelet serotonin in innate immune cell recruitment
Duerschmied, D. (2018) · Frontiers in bioscience · doi:10.2741/4732 · Cited by 66 · see citing works
Autocrine and paracrine regulatory functions of platelet serotonin
Mammadova‐Bach, E., Mauler, M., Braun, A., & Duerschmied, D. (2018) · Platelets · doi:10.1080/09537104.2018.1478072 · Cited by 66 · see citing works
Avcıl, S. (2018) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12659 · Cited by 64 · see citing works
Puangsri, P., & Ninla-aesong, P. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.114216 · Cited by 62 · see citing works
Prefrontal cortex activation during cognitive interference in nonsuicidal self-injury
Dahlgren, M. K., Hooley, J. M., Best, S. G., Sagar, K. A., Gönenç, A., & Gruber, S. A. (2018) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2018.04.006 · Cited by 61 · see citing works
Rojas‐Velasquez, D., Pluhar, E., Burns, P., & Burton, E. T. (2020) · Prevention Science · doi:10.1007/s11121-020-01147-x · Cited by 57 · see citing works
Wei, Y., Feng, J., Ma, J., Chen, D., & Chen, J. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.04.092 · Cited by 56 · see citing works
Fink, L. H. L., Anastasio, N. C., Fox, R. G., Rice, K. C., Moeller, F. G., & Cunningham, K. A. (2015) · Neuropsychopharmacology · doi:10.1038/npp.2015.46 · Cited by 55 · see citing works
Wang, J., Zhang, F., Jiang, F., Hu, L., Chen, J., & Wang, Y. (2021) · Journal of Clinical Laboratory Analysis · doi:10.1002/jcla.23935 · Cited by 54 · see citing works
Özyurt, G., & Binici, N. C. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.12.131 · Cited by 52 · see citing works
Beauchaine, T. P., Sauder, C. L., Derbidge, C. M., & Uyeji, L. L. (2019) · Development and Psychopathology · doi:10.1017/s0954579418000822 · Cited by 49 · see citing works
Kim, J. S., Kang, E.-S., Bahk, Y. C., Jang, S., Hong, K. S., & Baek, J. H. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00124 · Cited by 46 · see citing works
Blood cell count in antipsychotic-naive patients with non-affective psychosis
Garcia‐Rizo, C., Casanovas, M., Fernandez‐Egea, E., Oliveira, C., Meseguer, A., Cabrera, B., Mezquida, G., Bioque, M., Kirkpatrick, B., & Bernardo, M. (2019) · Early Intervention in Psychiatry · doi:10.1111/eip.12456 · Cited by 43 · see citing works
Liu, D., Czigány, Z., Heij, L. R., Bouwense, S. A. W., van Dam, R. M., Lang, S. A., Ulmer, T. F., Neumann, U. P., & Bednarsch, J. (2022) · Cancers · doi:10.3390/cancers14020438 · Cited by 41 · see citing works
Neuroimaging Studies of Nonsuicidal Self-Injury in Youth: A Systematic Review
Brañas, M. J. A. A., Croci, M. S., Salto, A. B. R., Doretto, V. F., Martinho, E., Macedo, M., Miguel, E. C., Roever, L., & Pan, P. M. (2021) · Life · doi:10.3390/life11080729 · Cited by 39 · see citing works
Russell, A. E., Ford, T., Gunnell, D., Heron, J., Joinson, C., Moran, P., Relton, C., Suderman, M., Hemani, G., & Mars, B. (2020) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2020.05.065 · Cited by 39 · see citing works
Dellu-Hagedorn, F., Rivalan, M., Fitoussi, A., & Deurwaerdère, P. D. (2018) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2017.0154 · Cited by 38 · see citing works
Plener, P. L., Fegert, J. M., Kaess, M., Kapusta, N. D., Brunner, R. M., Groschwitz, R. C., In‐Albon, T., Resch, F., & Becker, K. (2016) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917/a000463 · Cited by 29 · see citing works
Behavioral Treatment of Self-Injury: 2001 to 2016
Shawler, L. A., Russo, S. R., Hilton, J. L., Kahng, S., Davis, C. J., & Dorsey, M. F. (2019) · American Journal on Intellectual and Developmental Disabilities · doi:10.1352/1944-7558-124.5.450 · Cited by 27 · see citing works
Gorodetsky, E. K., Carli, V., Sarchiapone, M., Roy, A., Goldman, D. A., & Enoch, M. (2016) · Genes Brain & Behavior · doi:10.1111/gbb.12293 · Cited by 26 · see citing works
Uzun, N., & Akıncı, M. A. (2020) · Medical Hypotheses · doi:10.1016/j.mehy.2020.110440 · Cited by 22 · see citing works
Kumar, K., Srivastava, S., Sharma, B., Avasthi, R., & Kotru, M. (2021) · Cureus · doi:10.7759/cureus.17459 · Cited by 13 · see citing works
Brain 5-HT2A receptor binding and its neural network related to behavioral inhibition system
Kojima, K., Hirano, S., Kimura, Y., Seki, C., Ikoma, Y., Takahata, K., Ito, T., Yokokawa, K., Hashimoto, H., Kawamura, K., et al. (2022) · Brain Imaging and Behavior · doi:10.1007/s11682-021-00609-2 · Cited by 12 · see citing works
Wood, E. K., Kruger, R., Day, J. P., Day, S. M., Hunter, J. N., Neville, L., Lindell, S. G., Barr, C. S., Schwandt, M. L., Goldman, D. A., et al. (2021) · Neuropsychopharmacology · doi:10.1038/s41386-021-00994-8 · Cited by 9 · see citing works
Arafat, S. M. Y., Karim, A. K. M. B., Hossain, M. F., Menon, V., & Shoib, S. (2021) · Health Science Reports · doi:10.1002/hsr2.347 · Cited by 4 · see citing works
(2019) · PubMed
Flagged first, then by citations
Research works printed but not linked: 1
- Association AP: Other Conditions That May Be a Focus of Clinical Attention. In: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Volume 2, edn. U.S.; 2013:803-6.
Cited by
Sorted by citations
Velasco, A., Lengvenyte, A., Rodriguez-Revuelta, J., Jimenez-Treviño, L., Courtet, P., Garcia-Portilla, M., Bobes, J., & Sáiz, P. (2024) · European Psychiatry · doi:10.1192/j.eurpsy.2023.18 · Cited by 34 · see citing works
- Authors
- Zheng, Q., Liu, J., Ji, Y., Zhang, Y., Chen, X., & Liu, B.
- Affiliations
- Second Xiangya Hospital of Central South University (CN)
- Corresponding author
- Chen, XinChao
- Liu, BangShan
- Venue
- BMC Psychiatry
- Published
- 2022-09-19
- Volume
- 22
- Issue
- 1
- Pages
- 618-618
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC9483869
- OpenAlex
- W4296456197
- Semantic Scholar
- 692c3c283aad3fabf467a3cc3da71de493889687
- Cited by
- 26
- References
- 61
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 8 · 2023: 5
- FWCI
- 5.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- the Science and Technology Program Guidance Project of Xiamen City (No. 3502Z20214ZD1281)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- non-suicidal self-injury, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, systemic inflammation, adolescents, mood disorders, inflammatory markers, diagnostic thresholds
- MeSH terms
- Adolescent, Humans, Inflammation, Lymphocytes, Monocytes, Prognosis, Retrospective Studies, Self-Injurious Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
