Neutrophil/Lymphocyte, Platelet/Lymphocyte, and Monocyte/Lymphocyte Ratios in Mood Disorders

Major depressive disorder (MDD) and bipolar disorders (BDs), the most severe types of mood disorders (MDs), are considered as among the most disabling illnesses worldwide. Several studies suggested that inflammatory neuroinflammation might be involved in the pathophysiology of MDs while reporting increasing data on the relationships between these processes and classical neurotransmitters, hypothalamus-pituitary-adrenal axis (HPA), and neurotrophic factors. The assessment of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) in peripheral blood represents a simple method to evaluate the inflammatory status. The aim of the present paper was to review the literature on the possible relationships between NLR, PLR, and MLR in MDs and to comment on their possible wider use in clinical research. Thirty-five studies were included in the present review. The majority of them had higher values of these parameters, particularly NLR values in patients with MDs when compared to healthy subjects. The increase would appear more robust in patients with BD during a manic episode, thus indicating that it could be considered as both state and trait markers. In addition, increased NLR and PLR levels seem to represent prognostic elements for the early discovery of post-stroke depression. The findings of the present review would indicate the need to carry out further studies in this field. In particular, NLR, PLR, and MLR seem to be promising tools to detect economically and easily the activation of the inflammatory system and to perhaps evaluate the etiology and course of MDs. Again, they could suggest some information to better understand the relationship between inflammatory and cardiovascular disease and MDs, and thus, to provide clinical implications in terms of management and treatment.

Automated summary

Major depressive disorder (MDD) and bipolar disorders (BDs) are the most severe types of mood disorders (MDs) and are highly disabling worldwide. Inflammatory neuroinflammation may play a role in the pathophysiology of MDs, and there is increasing evidence of its relationship with neurotransmitters, the HPA axis, and neurotrophic factors. Evaluating ratios of neutrophil/lymphocyte, platelet/lymphocyte, and monocyte/lymphocyte in peripheral blood provides a simple method for assessing inflammatory status. This review aims to explore the possible relationships between these ratios and MDs and their potential use in clinical research. The majority of included studies reported higher values of these ratios, particularly in patients with BD during a manic episode, suggesting that they may serve as both state and trait markers. Furthermore, increased NLR and PLR levels appear to predict post-stroke depression. These findings highlight the need for further research and suggest that NLR, PLR, and MLR may be promising tools for evaluating the inflammatory system and understanding the etiology and course of MDs.