Abstract
ObjectivePlatelets are increasingly considered to play an important role in inflammation and are being regarded as a putative bridge linking mental diseases and inflammatory response. Platelet-associated haematological parameters including mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), systemic immune-inflammation index (SII), platelet to lymphocyte ratio (PLR), platelet to albumin ratio (PAR) and red blood cell distribution width (RDW) to platelet ratio (RPR), have been recently investigated as simple, easily available, and inexpensive inflammatory markers. In this study, we aimed is to use large-scale clinical data to study platelet parameters in patients with affective disorders, to further investigate the predictive power of platelet parameters for major depressive disorder (MDD) and bipolar disorder (BD).MethodsThe retrospective, naturalistic, cross-sectional study analysed the data of 14,007 Chinese affective disorder patients, including 4,801 patients with first-episode MDD, 4,098 patients with recurrent MDD, 3,444 patients with BD manic episodes and 1,664 patients with BD depressive episodes. Meanwhile, 6,847 healthy subjects were served as the control group. The differences in the MPV, PDW, PCT, SII, PLR, PAR, RPR and albumin among different groups were compared, and the contributing factors for the occurrence of MDD or BD were analysed.ResultsThere were significant differences in MPV, PDW, PCT, SII, PLR, RPR and albumin values among the study groups. In the subjects, patients experiencing BD manic episodes had the highest mean values of MPV and SII, patients experiencing BD depressive episodes had the lowest mean values of platelet counts and PAR, and patients with MDD had the highest mean values of PLR and RDW. The levels of MPV, PDW and albumin were independently correlated with MDD and BD, and they are important predictors for differentiating patients with MDD or BD from healthy controls.ConclusionsOur study demonstrated that different affective disorders have unique platelet parameter variation patterns, highlighting the role of platelet parameters and systemic inflammation in the pathophysiology of MDD and BD.
Highlights
Affective disorders are one of the most common and debilitating mental illnesses seen in clinical practice, which severely impact mood, sleep, diet and cognitive functions, often generating incapacities to manageWei et al BMC Psychiatry (2022) 22:150 emotion and behaviour, in some cases, they may even drive people to suicide [1, 2]
Given the inflammatory mechanisms involved in the occurrence of mood episodes in the affective disorders, we aimed to investigate whether there were differences in platelet parameters, including the platelet count, mean platelet volume (MPV), platelet distribution width (PDW), PCT, platelet to lymphocyte ratio (PLR), systemic immune-inflammation index (SII), RDW to platelet ratio (RPR) and platelet to albumin ratio (PAR), during the different mood episodes in affective disorders, including firstepisode major depression disorder (MDD), recurrent MDD, bipolar disorder (BD) depressive episodes and BD manic episodes
Our study found that the patients with MDD and BD both had increased red blood cell distribution width (RDW) levels compared to healthy controls (HCs), the MDD patients had higher RDW than BD patients, no differences in RDW were found between patients with BD depressive episodes and BD manic episodes
Summary
Affective disorders are one of the most common and debilitating mental illnesses seen in clinical practice, which severely impact mood, sleep, diet and cognitive functions, often generating incapacities to manageWei et al BMC Psychiatry (2022) 22:150 emotion and behaviour, in some cases, they may even drive people to suicide [1, 2]. The main types of affective disorders are major depression disorder (MDD) and bipolar disorder (BD), which seriously affect people’s social function, resulting in a reduced ability to cope with daily tasks in life and work [3, 4]. Considerable research on the pathogenesis of affective disorders in the past has made significant progress and has strengthened our understanding and treatment of affective disorders, there is still a subset of people who do not respond well to existing treatments [6]. Approximately one-third of patients have residual symptoms and functional impairment after treatment [7]. This phenomenon reminds us that the pathophysiological mechanisms of affective disorders need to be further studied
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