Altered Neutrophil-to-Lymphocyte Ratio in Patients with Non-Affective First Episode Psychosis and its Relationship with Symptom Severity and Cognitive Impairment

Signatures of immune dysregulation as clinical biomarker for psychosis have remained unclear. We aimed to compare the Neutrophil-to-lymphocyte ratio (NLR) of patients with acute non-affective first-episode psychosis (FEP) with healthy controls after accounting for emotional states, and explore their associations with symptom severity, onset profile and cognitive functions. The NLR was enumerated from complete blood count taken within a week of assessment. All FEP patients were assessed with Positive and Negative Syndrome Scale (PANSS) and the Clinician Global Impression-Severity (CGI-S) scores. Verbal memory and executive functions were assessed with the Cambridge Neuropsychological Test Automated Battery. Prevailing emotional state was measured with Beck Depression Inventory-II and Beck Anxiety Inventory. 27 eligible subjects screened out of 79 consecutive FEP patients with their age-/sex-matched controls were recruited. The FEP patients had an NLR of 1.886 higher than controls after accounting for emotional states. The NLR of FEP patients was positively associated with PANSS positive symptom, disorganization and excitation scores, as well as CGI-S scores. There was no significant correlation between NLR with duration of untreated psychosis and cognitive performances. These findings support using NLR as clinical biomarker in FEP, purporting further prospective study to measure NLR changes in the course of treatment.