Tracking complete blood count-derived indices during transition to euthymia in bipolar disorder: a longitudinal study


Gökçen O., Karataş K. S., AKKUŞ M., DÖNMEZ F., Yilmaz C., Konak M. A.

Biomarkers in Medicine, vol.19, no.11, pp.425-433, 2025 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 19 Issue: 11
  • Publication Date: 2025
  • Doi Number: 10.1080/17520363.2025.2511469
  • Journal Name: Biomarkers in Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, MEDLINE
  • Page Numbers: pp.425-433
  • Keywords: Bipolar disorder, complete blood count, depression, inflammation, mania
  • Kütahya Health Sciences University Affiliated: Yes

Abstract

Aim: This study aims to investigate changes in the CBC-related inflammatory indices in hospitalized bipolar disorder (BD) patients transitioning from a mood episode to a euthymic state. Method: BD patients hospitalized for mania or depression were assessed during hospitalization and one month post-discharge in euthymia. In both phases, CBC was assessed, along with the administration of YMRS, HDRS-17, and the CGI. Results: Ninety-four patients (58 manic, 36 depressive episodes) met the inclusion criteria at both phases. Significant decreases were observed in WBC (p < 0.001), neutrophils (p = 0.002), platelets (p = 0.038), NLR (neutrophil-to-lymphocyte ratio, p = 0.019), AISI (aggregate index of systemic inflammation, p < 0.001), dNLR (derived neutrophil-to-lymphocyte ratio, p = 0.007), SII (systemic immune inflammation index, p = 0.002), and SIRI (systemic inflammation response index, p = 0.003), while eosinophils (p = 0.003), EMR (eosinophil-to-monocyte ratio, p = 0.002), and ENR (eosinophil-to-neutrophil ratio, p = 0.001) increased. After a Bonferroni correction (p < 0.003125), changes in WBC, neutrophils, AISI, SII, SIRI, EMR, and ENR remained significant. Furthermore, differences were also noted between VPA users and non-users. Conclusion: The study highlights distinctive changes in CBC-related indicators during the transition to euthymia in BD patients. It is the first to investigate specific indices such as AISI, dNLR, EMR, and ENR in BD using a longitudinal design. The findings suggest that CBC-derived inflammation indices are promising tools for monitoring BD clinical progression.