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Review
. 2023 Apr 16;67(1):1-25.
doi: 10.1192/j.eurpsy.2023.18. Online ahead of print.

Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in depressed patients with suicidal behavior: A systematic review

A Velasco  1   2   3   4 , A Lengvenyte  5   6   7 , J Rodriguez-Revuelta  1   4   8 , L Jimenez-Treviño  1   4   8 , P Courtet  5   6 , M P Garcia-Portilla  1   2   3   4   8 , J Bobes  1   2   3   4 , P A Sáiz  1   2   3   4   8
Affiliations
Review

Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in depressed patients with suicidal behavior: A systematic review

A Velasco et al. Eur Psychiatry. .

Abstract

Background: Inflammatory biomarkers are reportedly increased in depressed patients. Several studies have been conducted using neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR). The objective of this systematic review was to study the relationship between these peripheral biomarkers and suicidality in depressed patients with/without suicidal behavior, including suicide attempts and ideation, and healthy controls.

Methods: We searched the following relevant terms in the PubMed, Web of Science, and Scopus databases published in the last 5 years. We assessed the methodological quality of included studies using the Oxford criteria and reviewed the evidence following PRISMA guidelines.

Results: Eleven studies were retained for the data synthesis, with a total sample of 1,701 participants, of which the majority (819) were patients with depression and suicidal behavior, 494 were depressed patients without suicidal behavior, and only 388 were healthy participants. Our results reinforce the idea that NLR could be an attractive, convenient, and cost-effective trait marker of suicidal vulnerability in patients with major depressive disorder (MDD).

Conclusion: Future large-scale replication studies are needed to examine the apparently understudied role of PLR and MLR in depressed patients in greater depth.

Keywords: Depression; Monocyte/lymphocyte ratio; Neutrophil/lymphocyte ratio; Platelet/lymphocyte ratio; Suicidal behavior.

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Conflict of interest statement

The authors declare none.

Figures

Figure 1.
Figure 1.
PRISMA 2020 flow diagram for new systematic reviews that included database searches.
See this image and copyright information in PMC

References

    1. World Health Organization. Suicide worldwide in 2019: global health estimates. World Health Organization. Licence: CC BY-NC-SA 3.0 IGO, https://apps.who.int/iris/rest/bitstreams/1350975/retrieve; (accessed on 21 April 2021).
    1. Bachmann S. Epidemiology of suicide and the psychiatric perspective. Int J Environ Res Public Health. 2018;15(7):1425. doi:10.3390/ijerph15071425. - DOI - PMC - PubMed
    1. Dong M, Wang SB, Wang F, Zhang L, Ungvari GS, Ng CH, et al. Suicide-related behaviours in schizophrenia in China: a comprehensive meta-analysis. Epidemiol Psychiatr Sci. 2019;28(3):290. doi:10.1017/S2045796017000476. - DOI - PMC - PubMed
    1. Velasco Á, Rodríguez-Revuelta J, Olié E, Abad I, Fernández-Peláez A, Cazals A, et al. Neutrophil-to-lymphocyte ratio: a potential new peripheral biomarker of suicidal behavior. Eur Psychiatry. 2020;63(1):e14. doi:10.1192/j.eurpsy.2019.20. - DOI - PMC - PubMed
    1. Bergmans RS, Kelly KM, Mezuk B. Inflammation as a unique marker of suicide ideation distinct from depression syndrome among U.S. adults. J Affect Disord. 2019;245:1052. doi:10.1016/j.jad.2018.11.046. - DOI - PMC - PubMed