Can Neutrophil Lymphocyte Ratio Predict the Likelihood of Suicide in Patients with Major Depression?
Open accessAbstract
Background Neutrophil lymphocyte rate (NLR), platelet lymphocyte rate (PLR), and systemic immune inflammatory index (SIII) are rates obtained from hemogram parameters, and they are biomarkers used for the diagnoses of many diseases and their severity, and prediction of disease. In addition to the NLR, PLR, and SIII, platelets, plateletcrit (PCT), and platelet distribution width (PDW), which are platelet indices, are also investigated as biomarkers in many diseases. There are limited studies on the use of hemogram derivates (NLR, PLR, and SIII) in the diagnosis and severity determination of psychiatric disorders. Objectives In this study, we aimed to investigate the effect of biomarkers and the proportions of NLR, PLR, and SIII, which are obtained from hemogram parameters, to distinguish or predict the patients with major depression who are likely to commit suicide. Materials and methods In this retrospective study, the files of patients referred to an educational research emergency and psychiatric outpatient clinic between June 2017 and December 2017 were evaluated. Patients who had been referred to the emergency polyclinic because of suicide attempts and those with major depression diagnosed at a psychiatric clinic were evaluated in this study. All hemogram evaluations were performed using the Sysmex XT-2000i Automated Hematology Analyzer (GMI, MN, USA). Results Twenty-seven suicide patients and 26 major depression groups meeting the study acceptance criteria were included in the evaluation. Of these patients, 40 were female and 13 were male. There was no difference between the groups in terms of age, body mass index, and complete blood count (CBC) parameters such as white blood cell (WBC), neutrophil count, lymphocyte count, eosinophil count, monocyte count, platelet indices, and NLR, PLR, SIII, which were obtained from the hemogram. Conclusion We found that the neutrophil to lymphocyte ratio and other biomarkers obtained from hemograms were higher in patients with major depression than those who had suicide attempts, but we found that this was not statistically significant.
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Five included studies were conducted in Turkey, one in India, two in Spain, one in Sweden, one in Israel, and one in Thailand.
“Five studies were conducted in Turkey [8, 20, 30–32], one in India [27], two in Spain [4, 29], one in Sweden [28], one in Israel [26], and one in Thailand [9].”
In two studies there was a nonsignificant tendency toward an increase in NLR in patients with a history of SA vs without any.
“First, in two studies there was a (nonsignificant) tendency toward an increase in NLR in patients with a history of SA vs without any [29, 32].”
In Gundogdu Meydaneri and Meydaneri, PLR tended to be higher in the suicide attempt group, but this difference was not statistically significant.
“PLR tended to be higher in the SA group. However, this difference was not statically significant”
In three other studies, the difference in PLR between patients with a history of SA and those without was not observed.
“Conversely, this difference was not observed in three other studies [20, 29, 32] (Table 2).”
In Gundogdu Meydaneri and Meydaneri, NLR tended to be higher in the suicide attempt group, but this difference was not statistically significant.
“NLR tended to be higher in the SA group. However, this difference was not statically significant”
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Cites
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“It was reported that the NLR value of individuals that attempted suicide was higher than in those with major depression, but this difference was not statistically signifi cant (23).”
Department of Psychiatry, G. U., Kucukkarapinar, M., Erbil, D., Department of Psychiatry, G. U., Keles, İ., Department of Psychiatry, G. U., Karadag, F., & Department of Psychiatry, G. U. (2024) · Psychiatry and Clinical Psychopharmacology · doi:10.5152/pcp.2024.23760 · Cited by 14 · see citing works
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NEUTROPHILIC LEUKOCYTOSIS IN NONFATAL SUICIDAL HANGING: A CASE SERIES
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“Another study found that among 27 suicide patients and 26 major depression groups, NLR was higher among the patients who had suicide attempts (Gundogdu Meydaneri & Meydaneri 2018).”
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“NLR was also shown to be higher among individuals who tried suicide in both depression and suicide groups, according to another study.(11) It has been proposed as a marker of low-grade systemic inflammation in mental disorders, and preliminary evidence reveals that NLR is higher in suicide attempters with and without…”
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BLOOD DERIVED INFLAMMATORY MARKERS IN COMPLETED SUICIDE: RESULTS FROM A CASE-CONTROL STUDY
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“However, con fl icting evidence exists, as Meydaneri (18) found no signi fi cant difference in NLR, PLR and other immune biomarkers between suicidal patients and non-suicidal patients with depressive disorders.”
Suicidal behavior and inflammation: neutrophil to lymphocyte ratio
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Гематологические коэффициенты системного воспаления как потенциальные биомаркеры суицида
Gorbunova, A. P., Rukavishnikov, G. V., Kasyanov, E. D., Kibitov, A. O., & Mazo, G. E. (2024) · Суицидология · doi:10.32878/suiciderus.24-15-01(54)-31-52
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“This finding is in line with previous studies in other neuropsychiatric disorders [45-47], suggesting that immune abnormalities and inflammation may play a role in the pathogenesis of SI in patients with SZ.”
- Authors
- Gundogdu Meydaneri, G., & Meydaneri, S.
- Affiliations
- Maltepe University (TR)
- Corresponding author
- Meydaneri, Sertac
- ORCID
- Meydaneri, Sertac
- Venue
- Cureus
- Published
- 2018-04-19
- Volume
- 10
- Issue
- 4
- Pages
- e2510-e2510
- ISSN
- 2168-8184 (ISSN-L)
- PMC
- PMC6007446
- OpenAlex
- W2802425704
- Cited by
- 29
- References
- 19
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 10 · 2020: 3 · 2019: 1
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Cureus (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- neutrophil-to-lymphocyte ratio, major depressive disorder, suicide attempts, platelet-to-lymphocyte ratio, systemic immune-inflammation index, inflammatory markers, suicide risk prediction
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