Citation

Nasrallah HA. J. Clin. Psychiatry 2024; 85(2): 24com15310.

Copyright

(Copyright © 2024, Physicians Postgraduate Press)

DOI

10.4088/JCP.24com15310

PMID

38780530

Abstract

There are numerous lines of evidence that psychosis is associated with neuroimmune dysregulation and elevated subtypes of inflammatory biomarkers. In addition, many studies have reported a significant increase in adult mood and psychotic disorders associated with childhood maltreatment and trauma (physical, sexual, or emotional abuse or severe neglect), mediated by epigenetic dysregulation of neuroimmune and neuroendocrine pathways.1

The neutrophil-to-lymphocyte ratio (NLR) is a biomarker for immune response in a wide range of medical conditions including infections, heart disease, stroke, cancer, diabetes, and anemia, as well as stress and psychiatric disorders.2 NLR >3.0 or <0.7 is considered pathological, and values ranging between 2.3 and 3.0 can serve as an early warning sign of pathology (like cancer, atherosclerosis, inflammation, and psychiatric disorders). Severe stress or inflammation can dramatically increase the NLR up to 11-30 or even higher.2

A published study3 reported that a healthy population usually has an NLR of 1.72 ± 0.74 compared to NLR of 1.96 ± 1.11 in a sample of first-episode psychosis. NLR was higher in nonremitting patients,3 suggesting that treatment-resistant psychosis may have a more serious immune dysregulation. Another study reported a significant decrease in NLR at remission of psychosis.4 Elevation of NLR is also a marker of endothelial dysfunction, which can predict cardiovascular disease in patients with psychosis.

Language: en

Keywords

*Adverse Childhood Experiences; *Biomarkers/blood; *Psychotic Disorders/classification/diagnosis/blood; Child; Humans; Inflammation