Association between neutrophil to lymphocyte ratio and mood polarity in adolescents admitted to an inpatient psychiatric ward

Adi Drapisz, Matan Avrahami, David H. Ben Dor, Yael Bustan, Ehud Mekori-Domachevski, Abraham Weizman, Ran Barzilay

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Inflammatory processes are associated with mood disorders, but data on pediatric patients are scarce. The aim of this study was to investigate a possible association between elevated neutrophil/lymphocyte ratio (NLR) - a marker of inflammation and mood polarity (manic/depressed) in adolescents, admitted between 2010 and 2015 due to a mood disorder episode and to an adolescent inpatient ward. Electronic medical records of 305 patients (aged 10-19 years, 60.6% males) admitted during the study period due to a mood disorder episode were reviewed. Of these, 63 were diagnosed with manic episodes and 242 with depressive episodes. Multivariate analyses were used to compare NLR between and within the two groups, covarying for age, sex, and antipsychotic use. NLR was significantly higher in the manic episode group compared with the depression one. Moreover, in inpatients with multiple hospitalizations, the NLR was higher during their manic episodes than that during their nonmanic states. These results suggest that, as has been reported in adults with bipolar disorder, inflammatory mechanisms may be involved in adolescents' mood disorders as well, particularly in the manic episodes. Thus, clinicians may consider adding anti-inflammatories as part of the treatment of these patients.

Original languageEnglish
Pages (from-to)242-246
Number of pages5
JournalInternational Clinical Psychopharmacology
Issue number6
StatePublished - 1 Nov 2022


FundersFunder number
Lifespan Brain Institute of Children's Hospital of Philadelphia
Lifespan Brain Institute of Children’s Hospital of Philadelphia
Penn Medicine, University of Pennsylvania
National Institute of Mental HealthK23MH120437
National Institute of Mental Health


    • adolescents
    • depression
    • inflammation
    • mania
    • mood disorder


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