Popov Mikhail, Popov Yuri, Kosterin Dmitry, Lepik Olga
Consort Psychiatr. 2024 Jul 6;5(2):45-61. doi: 10.17816/CP15514. eCollection 2024.
Inflammatory hematological ratios (IHRs), such as neutrophil to lymphocyte, monocyte to lymphocyte, and platelet to lymphocyte ratios, are associated with mental disorders, symptoms severity, and the disease phase. Evidence from the studies in adult patients has been summarized in systematic reviews and meta-analyses. The results of the studies in adolescents remain poorly systematized.
To summarize the findings from the studies that investigated the relationship of IHRs with mental disorders in adolescent patients.
This scoping review included studies of IHRs in patients aged 10-19 years with mental disorders (other than anorexia nervosa), published in English by December 31, 2023. The search for relevant papers was performed in MEDLINE. The studies were categorized into two groups: studies with external controls (healthy adolescents) and studies with internal controls (patients in different phases of mental disorder, with or without self-harm/suicidal behaviors).
A total of 11 studies were included in the review (all cross-sectional ones). The results of these studies demonstrate that 1) adolescents with mental disorders (major depressive disorder, psychotic disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, substance use disorders) have higher IHR values than individuals of the same age without corresponding disorders (5 studies); 2) IHR values are positively correlated with the severity of psychopathological symptoms (1 study); 3) higher IHR values are associated with the phase of the mental disorder - manic episode in bipolar disorder (1 study) and exacerbation of psychosis in psychotic disorders (1 study); and 4) higher IHR values are associated with self-harm/suicidal behaviors - suicide attempts (1 study) and non-suicidal self-injury (1 study).
IHRs are associated with mental disorders in adolescents, and higher IHR values are associated with a more severe/acute clinical presentation (severity of symptoms, mania, acute psychosis, self-harm/suicidal behaviors). Further studies of higher methodological quality are needed to evaluate the diagnostic and prognostic value of IHRs as biomarkers of mental disorders in adolescence.
炎症性血液学比值（IHRs），如中性粒细胞与淋巴细胞比值、单核细胞与淋巴细胞比值以及血小板与淋巴细胞比值，与精神障碍、症状严重程度及疾病阶段相关。成年患者研究的证据已在系统评价和荟萃分析中进行了总结。青少年研究的结果仍缺乏系统性整理。
总结研究青少年患者IHRs与精神障碍关系的研究结果。
本范围综述纳入了2023年12月31日前以英文发表的10至19岁精神障碍（神经性厌食症除外）患者IHRs的研究。在MEDLINE中检索相关论文。研究分为两组：有外部对照（健康青少年）的研究和有内部对照（处于精神障碍不同阶段、有或无自我伤害/自杀行为的患者）的研究。
本综述共纳入11项研究（均为横断面研究）。这些研究结果表明：1）患有精神障碍（重度抑郁症、精神分裂症、强迫症、注意力缺陷多动障碍、物质使用障碍）的青少年的IHR值高于同龄无相应障碍的个体（5项研究）；2）IHR值与精神病理症状的严重程度呈正相关（1项研究）；3）较高的IHR值与精神障碍阶段相关——双相情感障碍的躁狂发作（1项研究）和精神分裂症的精神病加重（1项研究）；4）较高的IHR值与自我伤害/自杀行为相关——自杀未遂（1项研究）和非自杀性自我伤害（1项研究）。
IHRs与青少年精神障碍相关，较高的IHR值与更严重/急性的临床表现（症状严重程度、躁狂、急性精神病、自我伤害/自杀行为）相关。需要进一步开展更高质量的研究，以评估IHRs作为青少年精神障碍生物标志物的诊断和预后价值。
