The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry · 2025
Bipolar disorder and inflammation: a clinical study of NLR and dNLR across mood states and subtypes.
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Carbone Manuel Glauco, Marazziti Donatella
Аннотация
OBJECTIVES: Bipolar disorder (BD) has been repeatedly linked to immune dysregulation, yet the clinical specificity of neutrophil-based indices remains unclear. This brief report examined whether the neutrophil-to-lymphocyte ratio (NLR) and derived NLR (dNLR) vary across BD subtypes, mood states, and treatments, focusing on their potential as state-sensitive markers rather than direct indicators of inflammation.
METHODS: We retrospectively analysed 54 inpatients with BD diagnosed per DSM-5. Complete blood counts were used to compute NLR and dNLR, alongside socio-demographic, clinical (subtype, mood state, psychosis), and pharmacological data. Non-parametric tests with effect-size estimates and a multivariable sensitivity model were applied. Illness severity was assessed with YMRS and HAM-D.
RESULTS: NLR and dNLR were significantly higher in BD-I patients with psychotic mania than in BD-II patients in depression. Lithium treatment was associated with lower NLR/dNLR levels. No significant correlations emerged with YMRS or HAM-D scores. The apparent reduction in NLR among comorbid ADHD cases was exploratory only due to the very small subgroup (n = 2).
CONCLUSIONS: NLR and dNLR appear to act as state-dependent peripheral markers in BD, reflecting acute psychotic mania and lithium modulation rather than trait inflammation. These preliminary findings warrant confirmation in larger, longitudinal cohorts.
METHODS: We retrospectively analysed 54 inpatients with BD diagnosed per DSM-5. Complete blood counts were used to compute NLR and dNLR, alongside socio-demographic, clinical (subtype, mood state, psychosis), and pharmacological data. Non-parametric tests with effect-size estimates and a multivariable sensitivity model were applied. Illness severity was assessed with YMRS and HAM-D.
RESULTS: NLR and dNLR were significantly higher in BD-I patients with psychotic mania than in BD-II patients in depression. Lithium treatment was associated with lower NLR/dNLR levels. No significant correlations emerged with YMRS or HAM-D scores. The apparent reduction in NLR among comorbid ADHD cases was exploratory only due to the very small subgroup (n = 2).
CONCLUSIONS: NLR and dNLR appear to act as state-dependent peripheral markers in BD, reflecting acute psychotic mania and lithium modulation rather than trait inflammation. These preliminary findings warrant confirmation in larger, longitudinal cohorts.