Suicidal thoughts are associated with platelet counts in adolescent inpatients

Is Vitamin B12 Level a Reliable Predictor of Psychosis Severity in Male Patients with Megaloblastic Anemia at a Single Tertiary Hospital?

Background

Megaloblastic anemia (MA) occurs due to ineffective erythropoiesis, which results from impaired DNA synthesis in the hematopoietic precursors and intramedullary hemolysis. MA’s most common cause is nutritional deficiencies of either cobalamin (vitamin B12) or folate (vitamin B6). This study aims to determine the association between MA caused by vitamin B12 deficiency and psychosis among psychotic male patients in Mental Health Hospital at Taif, Saudi Arabia.

Methods

Fifty psychotic male patients, aged 48.58±1.72, were recruited from the Mental Health Hospital at Taif, Saudi Arabia, in addition to 54 sex-matched healthy controls. The following tests were run: complete blood count (CBC), liver function tests (LFT), serum levels of vitamin B12, folate, and C-reactive protein (CRP).

Results

The CBC showed that RBCs count, haemoglobin, haematocrit, platelets count, mean platelets volume (MPV), and absolute lymphocyte count were significantly lower in psychotic patients versus healthy controls (P=0.007, P=0.002, P=0.001, P=0.004, P=0.0001, and P=0.005, respectively). In contrast, the eosinophil absolute count and basophil percentage were significantly higher in psychotic patients versus controls (P=0.009, P=0.0001, respectively). Vitamin B12 levels were insignificantly decreased in psychotic patients versus healthy group. There were significant negative correlations between serum levels of VitB12 and negative symptoms (r=−0.381, P=0.006) and hallucination (r=−0.297, P=0.036).

Conclusion

These findings indicate no link between MA induced by VitB12 insufficiency and psychosis among psychotic patients. However, low serum VitB12 can predict the severity of some psychosis signs, including hallucinations and negative symptoms. Therefore, monitoring VitB12 levels and its supplementation in psychotic patients is recommended to improve their symptoms.

Elevated Platelet Parameter in First-Episode Schizophrenia Patients: A Cross-Sectional Study

Serotonin (5-HT) and inflammation are 2 major hypotheses in schizophrenia (SZ) pathogenesis, both of which involve platelets. However, the association between platelet and SZ has not been well studied. The aim of this study was to evaluate changes of platelet count (PLT), mean platelet volume (MPV), platelet-large cell ratio (P-LCR), platelet distribution width (PDW), and plateletcrit (PCT) in patients with first-episode schizophrenia (FES). Meanwhile, 3 inflammation markers, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR), were evaluated. Complete blood count of 106 FES patients, 82 first-episode depression (FED) patients, and 120 healthy controls (HCs) were compared. In addition, PLR, NLR, and MLR were calculated and compared among 3 groups. Our data suggested that PLT, MPV, P-LCR, PDW, PCT, NLR, PLR, and MLR in FES patients were significantly increased than those in the HCs (P < 0.01 or P < 0.05, respectively). PLT, PCT, PLR, and MLR in FED patients were significantly higher than those in the HCs (P < 0.01). However, no significant difference in MPV, P-LCR, and NLR was identified between FED patients and HCs (P > 0.05). Moreover, MPV, P-LCR, PDW, NLR, and MLR in FES patients were significantly higher than those in FED patients (P < 0.01 or P < 0.05, respectively). The elevation of PLT, MPV, P-LCR, PDW, PCT, NLR, PLR, and MLR in FES patients supported 5-HT and inflammation hypotheses in SZ pathogenesis. Further, our data suggested that increasing levels of MPV, P-LCR, PDW, NLR, and MLR might help to distinguish FES from FED. Clinical Trials.gov ID: 2018JJ2580.

Increased neutrophil-lymphocyte ratios in depressive adolescents is correlated with the severity of depression

We aimed to investigate the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in adolescents with major depression. Sixty-seven adolescents and 121 healthy controls were enrolled in the study. The diagnosis was made by using both the Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version and the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition. The severity of depressive symptoms was evaluated using the Beck depression inventory (BDI). The neutrophil-lymphocyte ratios of the adolescents with depression were significantly higher than those of the control group, even after adjusting for age, sex, BMI, and BDI scores, whereas there was no significant difference in platelet-lymphocyte ratios. A positive correlation between the severity of depression and neutrophil-lymphocyte ratios and platelet-lymphocyte ratios were determined in the case group. The results of this study may promote the hypothesis that inflammation plays an important role in the etiology of major depression in adolescents.

Platelet parameters (PLT, MPV, P-LCR) in patients with schizophrenia, unipolar depression and bipolar disorder

There are no studies comparing platelet parameters platelet parameters (platelet count (PLT), mean platelet volume (MPV) and platelet large cell ratio (P-LCR)) between patients with schizophrenia, bipolar disorder and unipolar depression. Therefore, the aim of this study was to determine and compare differences in PLT, MPV and P-LCR in patients with schizophrenia, unipolar depression and bipolar disorder. This was a retrospective, cross-sectional, naturalistic study of 2377 patients (schizophrenia n=1243; unipolar depression n=791; bipolar disorder n=343, including bipolar depression n=259 and mania n=84). There were significant differences for PLT, MPV and P-LCR values between study groups. A significant percentage of patients with bipolar disorder had abnormal (too low or too high) number of platelets. Negative correlation between PLT and age was found in all study groups and positive correlation between age and MPV and P-LCR was found in patients with schizophrenia.

Escape from Discrepancy: Self-Esteem and Quality of Life as Predictors of Current Suicidal Ideation Among Individuals with Schizophrenia

While suicidal ideation represents an "early warning" sign for suicidal behavior, studies examining suicidal ideation have been limited and largely atheorethical among those with schizophrenia. Informed by the Escape Theory of Suicide, we investigated the relationship between discrepancy factors, in the form of self-esteem and quality of life (QoL), and suicidal ideation. In a sample of 162 individuals with Schizophrenia, hierarchical logistic regression was employed to examine the contribution of (1) demographic (2) clinical and (3) discrepancy factors to suicidal ideation. A mediation analysis was performed to determine if self-esteem mediated the relationship between QoL and suicidal ideation. While QoL (in social relationships) and self-esteem collectively added value to predicting suicidal ideation beyond other factors, only self-esteem remained significant in the final hierarchical model. Self-esteem was found to mediate the relationship between QoL and suicidal ideation. Findings support Escape Theory in schizophrenia, marking self-esteem and QoL as targets for intervention.

Seasonal changes in gene expression represent cell-type composition in whole blood

Seasonal patterns in behavior and biological parameters are widespread. Here, we examined seasonal changes in whole blood gene expression profiles of 233 healthy subjects. Using weighted gene co-expression network analysis, we identified three co-expression modules showing circannual patterns. Enrichment analysis suggested that this signal stems primarily from red blood cells and blood platelets. Indeed, a large clinical database with 51 142 observations of blood cell counts over 3 years confirmed a corresponding seasonal pattern of counts of red blood cells, reticulocytes and platelets. We found no direct evidence that these changes are linked to genes known to be key players in regulating immune function or circadian rhythm. It is likely, however, that these seasonal changes in cell counts and gene expression profiles in whole blood represent biological and clinical relevant phenomena. Moreover, our findings highlight possible confounding factors relevant to the study of gene expression profiles in subjects collected at geographical locations with disparaging seasonality patterns.