Neutrophil-lymphocyte ratio across psychiatric diagnoses: a cross-sectional study using electronic health records

Brinn, Aimee and Stone, James (2020) Neutrophil-lymphocyte ratio across psychiatric diagnoses: a cross-sectional study using electronic health records. BMJ Open, 10. e036859 1-8. ISSN 2044-6055

[img] PDF - Published Version
Available under License Creative Commons Attribution.

Download (401kB)


The 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.

A cross-sectional methodology was employed to retrospectively analyse electronic health records and records derived from a national health survey.

A secondary mental healthcare service consisting of four boroughs in South London.

A 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.

NLR 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.

Elevated 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.

Item Type: Article
Keywords: anxiety disorders, depression & mood disorders, mental health, personality disorders, schizophrenia & psychotic disorders, Adolescent, Adult, Aged, Aged, 80 and over, Electronic Health Records, Female, Humans, Leukocyte Count, London, Lymphocytes, Male, Middle Aged, Neutrophils, Retrospective Studies, Young Adult
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 03 Oct 2022 13:49
Last Modified: 03 Oct 2022 14:00

View download statistics for this item

📧 Request an update