Home Mental Health & Well-Being There’s an Elevated Neutrophil-to-Lymphocyte Ratio in Suicidal Individuals, According to New Study

There’s an Elevated Neutrophil-to-Lymphocyte Ratio in Suicidal Individuals, According to New Study

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A recent systematic review and meta-analysis published in the journal Molecular Psychiatry, has revealed significant insights into the link between peripheral immune cell profiles and suicidal ideation (SI) and suicidal behaviour (SB). This comprehensive study, which analysed data from numerous observational studies, underscores the potential of immune markers in understanding and possibly predicting suicidality.

Previous research has established that immune-inflammatory pathways play a crucial role in the pathophysiology of major depressive episodes (MDE). However, it remained unclear whether these immunological changes are distinct in individuals experiencing suicidal ideation or behaviour, independent of depression. Daray’s study aimed to fill this gap by examining peripheral immune cell profiles across samples with SI/SB and comparing them to healthy controls and patients with MDE.

The researchers conducted a systematic literature search in databases like MEDLINE, Embase, and PsycINFO for articles published up to June 2023. They included studies that investigated the relationship between peripheral blood cells and SI/SB. The selected studies examined various immune cell counts or ratios, such as white blood cells (WBC), neutrophils, and the neutrophil-to-lymphocyte ratio (NLR).

Meta-analyses were performed using a random-effects model to calculate standardised mean differences (SMDs) and confidence intervals (CIs) for immune cell counts between groups with and without SI/SB. The study included data from 19 studies comprising 139 unique comparisons, involving 1973 individuals with SI/SB and 5537 comparison subjects.

The analysis revealed that individuals with SI/SB had higher WBC and neutrophil counts compared to controls, indicating an inflammatory process. Specifically, WBC counts had an SMD of 0.458 and neutrophil counts had an SMD of 0.581, both showing significant elevations in the SI/SB group. The NLR, a potential marker for inflammation, was also notably higher in individuals with SI/SB.

Interestingly, the study found no significant differences in lymphocyte counts between the SI/SB group and controls, suggesting that the elevated NLR was primarily driven by increased neutrophil counts. This pattern was also observed in comparisons among participants with and without depression, where increased NLR, monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were seen in depressed individuals with SI/SB compared to those without SI/SB.

These findings highlight the potential utility of immune markers as part of a multi-modal approach for risk stratification and therapeutic monitoring in individuals with SI/SB. The broad alterations in peripheral immune cell populations and their ratios observed in the study indicate an immune activation or dysfunction associated with suicidality.

The study’s results suggest that immune dysfunction associated with SI/SB cannot be solely attributed to depressive symptoms, as similar immunological changes were evident when comparing MDE individuals with and without SI/SB. This distinction is crucial for developing targeted interventions and improving clinical outcomes for individuals at risk of suicide.

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