ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2020
Neutrophil-to-lymphocyte ratio: A potential new peripheral biomarker of suicidal behavior.
Article in European psychiatry : the journal of the Association of European Psychiatrists, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
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Who cites it
48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Inflammation and nitro-oxidative stress in current suicidal attempts and current suicidal ideation: a systematic review and meta-analysis.Molecular psychiatry · 2022Pooled it
- Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis.Frontiers in psychiatry · 2022Pooled it
- Article
- Transcription-protein dissociation reveals disrupted cellular stress pathways in the prefrontal cortex of depression and schizophrenia subjects.Molecular biomedicine · 2026Article
- The neutrophil-to-lymphocyte ratio: a psychoneuroimmunological nexus linking depression and cardiovascular comorbidity.European archives of psychiatry and clinical neuroscience · 2026Article
- Inflammatory ratios as predictors of length of hospitalization in psychiatric patients: A multicenter study.European archives of psychiatry and clinical neuroscience · 2026Article
- Inflammatory Parameters in Patients with Suicide Attempts by Drug Overdose: A Comparative Study with a Comparison Group.Medicina (Kaunas, Lithuania) · 2026Observational
- The relationship between suicidal behavior and hematological inflammatory parameters: a retrospective cohort study.Frontiers in psychiatry · 2026Article
- Analysis of complete blood counts and derived inflammatory indices with non-suicidal self-injury and suicide attempt in adolescents with major depressive disorder.Frontiers in psychiatry · 2026Article
- Low-grade inflammatory parameters may be associated with recent suicide attempts - a naturalistic study among psychiatric inpatients with depressive disorders.Frontiers in psychiatry · 2026Article
- Association between Suicidal Ideation and Immune Parameters in First-episode Patients with Schizophrenia.Current neuropharmacology · 2026Article
- Acute Poisonings, Suicidality and Systemic Inflammatory Load in Pregnant Women.Psychiatry and clinical psychopharmacology · 2025Article
- The association between major depressive disorder and generalized anxiety disorder with hematological indices in the Rafsanjan youth cohort study.Scientific reports · 2025Article
- Systemic inflammation as a mediator in the link between obesity and depression: Evidence from a nationwide cohort study.BMC psychiatry · 2025Article
- Let's Move Towards Precision Suicidology.Current psychiatry reports · 2025Review
- Peripheral biological correlates of suicidality in children and adolescents: A systematic review and meta-analysis.iScience · 2025Article
- Pan-immune-inflammation value: a new prognostic index in operative laryngeal and pharyngeal carcinomas.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Article
- Sedentary behavior is associated with systemic immune-inflammation index and systemic inflammation response index levels: a cross-sectional analysis of the NHANES 2011-2018.Frontiers in public health · 2025Article
- Elevated monocyte-to-lymphocyte ratio, C-reactive protein and further inflammatory parameters as potential biomarkers of suicide risk in bipolar I disorder.Frontiers in psychiatry · 2025Article
- Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as mortality predictors in acute Aluminum phosphide (grain pills) poisoning: clinical insights and risk assessment.Toxicology research · 2024Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality.
methodsWe evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA).
resultsThree hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266-2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%).
conclusionsOur data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.
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