ArticleBMJ open2020
Neutrophil-lymphocyte ratio across psychiatric diagnoses: a cross-sectional study using electronic health records.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
38 citing papers in PubMed, 5 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Neutrophil to lymphocyte ratio in urolithiasis: a systematic review.BMC urology · 2025Pooled it
- Diagnostic accuracy of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio in rheumatoid arthritis: a systematic review and meta-analysis.Clinical and experimental medicine · 2024Pooled it
- A systematic review and meta-analysis of the diagnostic accuracy of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio in systemic lupus erythematosus.Clinical and experimental medicine · 2024Pooled it
- The association between the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio and systemic sclerosis and its complications: a systematic review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Perturbations in Gut Microbiota Composition in Psychiatric Disorders: A Review and Meta-analysis.JAMA psychiatry · 2021Pooled it
- Temporal coupling of cortisol and immune cell responses in acute psychosocial stress.Brain, behavior, & immunity - health · 2026Article
- Complete Blood Count-Derived Inflammatory Indices in Catatonia: A Retrospective Matched Case-Control Study.Diagnostics (Basel, Switzerland) · 2026Article
- Linking peripheral low-grade inflammation and blood-cerebrospinal fluid barrier leakage in schizophrenia spectrum disorders - A retrospective analysis.Brain, behavior, & immunity - health · 2026Article
- The kynurenine pathway in depression and schizophrenia: convergent signals, divergent states, and clinical signatures.EXCLI journal · 2026Review
- A psychoneuroimmunological underpinnings of the relationship between childhood trauma, loneliness, and depression in older adults.Translational psychiatry · 2025Article
- Comorbidity patterns and immune-metabolic differences in patients with acute-episode of schizophrenia spectrum disorders.Schizophrenia (Heidelberg, Germany) · 2025Article
- Article
- Effects of canine-assisted intervention on stress and depression in humans.Journal of animal science and technology · 2025Review
- Analysis of the association between long-term exposure to low-dose ionizing radiation and dyslipidemia and its components in medical radiologists: The mediating role of inflammatory markers.International journal of cardiology. Cardiovascular risk and prevention · 2025Article
- Monitoring neutrophil-to-lymphocyte ratio dynamics for personalized treatment in adolescent eating disorders: a retrospective cohort study.Journal of eating disorders · 2025Article
- Relationship between Thought Style, Emotional Response, Post-Traumatic Growth (PTG), and Biomarkers in Cancer Patients.International journal of environmental research and public health · 2024Article
- Inflammatory mediators in major depression and bipolar disorder.Translational psychiatry · 2024Review
- Neutrophil-to-lymphocyte ratio as a predictive biomarker for early diagnosis of depression: A narrative review.Brain, behavior, & immunity - health · 2024Review
- Lymphocyte-related ratios in methamphetamine-induced psychotic disorder in Taiwan, comparing with patients with schizophrenia.Addiction biology · 2024Article
- Inflammatory Hematological Ratios in Adolescents with Mental Disorders: A Scoping Review.Consortium psychiatricum · 2024Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe main objective of this study was to compare neutrophil-lymphocyte ratio (NLR), a marker of systemic inflammation, between patients diagnosed with International Classification of Diseases 10th Revision (ICD-10) psychiatric disorders and control participants.
designA cross-sectional methodology was employed to retrospectively analyse electronic health records and records derived from a national health survey.
settingA secondary mental healthcare service consisting of four boroughs in South London.
participantsA diverse sample of 13 888 psychiatric patients extracted from South London and Maudsley electronic health records database and 3920 control participants extracted from National Health and Nutrition Survey (2015-2016) were included in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary: NLR levels in patients with mental health diagnoses, NLR between patients with different mental health diagnoses. Secondary: relationship of NLR to length of hospitalisation and to mortality.
resultsNLR was elevated compared with controls in patients with diagnoses including dementia, alcohol dependence, schizophrenia, bipolar affective disorder, depression, non-phobic anxiety disorders and mild mental retardation (p<0.05). NLR also correlated with age, antipsychotic use and hypnotic use. NLR was found to be higher in individuals of 'white' ethnicity and lower in individuals of 'black' ethnicity. Elevated NLR was associated with increased mortality (β=0.103, p=2.9e-08) but not with hospital admissions or face-to-face contacts.
conclusionsElevated NLR may reflect a transdiagnostic pathological process occurring in a subpopulation of psychiatric patients. NLR may be useful to identify and stratify patients who could benefit from adjunctive anti-inflammatory treatment.
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Registered trials
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