Association of the Neutrophil-to-Platelet Ratio With Response to ECT in Adolescents With MDD: New Study From China
Out on PubMed, from authors in China, is this paper:
Association of the neutrophil-to-platelet ratio with response to electroconvulsive therapy in adolescents with major depressive disorder.
Front Psychiatry. 2024 Nov 25;15:1413608. doi: 10.3389/fpsyt.2024.1413608. eCollection 2024.PMID: 39655209
The abstract is copied below:
Background: Major depressive disorder (MDD) is one of the most serious mental disorders affecting adolescents worldwide. Electroconvulsive therapy (ECT) is widely acknowledged as a first-line treatment for severe depression, but the clinical response varies. Neutrophils and platelets are both related to the progression of MDD. The aim of this study was to investigate the correlation between the neutrophil-to-platelet ratio (NPR) during the acute phase and the effectiveness of ECT treatment.
Methods: A total of 138 adolescent MDD patients who received ECT were included in the study. Neutrophil and platelet levels were obtained upon admission. At the same time, treatment response was the primary outcome measure, defined as a reduction of ≥ 50% in the HAMD-17 score from baseline to treatment endpoint, and the secondary outcome measure was remission of depression, defined as a HAMD-17 score ≤ 7.
Results: After receiving ECT, 103(74.6%) of all patients responded to treatment and 72(52.2%) achieved remission. Non-responders/non-remitters to ECT tended to have higher levels of NPR at baseline compared to ECT responders/remitters [Non-responder: 3.4 (2.5-4.8) vs 2.7 (2.2-3.5), P = 0.002; Non-remitter: 0.014 (0.011-0.017) vs 0.011 (0.008-0.015), P = 0.03]. In multiple logistic regression, high NPR (≥ 0.014) remained independently associated with ECT non-response/non-remission after adjusting for confounding factors [Non-responder: OR = 4.911, 95% CI (2.052 - 11.754), P < 0.001; Non-remitter: OR = 2.704, 95% CI (1.262 - 5.796), P = 0.011].
Conclusion: High NPR correlates with poor ECT efficacy in adolescents with MDD, particularly among female and overweight patients.
Keywords: adolescents; electroconvulsive therapy; major depressive disorder; neutrophil-to-platelet ratio; response.
Methods: A total of 138 adolescent MDD patients who received ECT were included in the study. Neutrophil and platelet levels were obtained upon admission. At the same time, treatment response was the primary outcome measure, defined as a reduction of ≥ 50% in the HAMD-17 score from baseline to treatment endpoint, and the secondary outcome measure was remission of depression, defined as a HAMD-17 score ≤ 7.
Results: After receiving ECT, 103(74.6%) of all patients responded to treatment and 72(52.2%) achieved remission. Non-responders/non-remitters to ECT tended to have higher levels of NPR at baseline compared to ECT responders/remitters [Non-responder: 3.4 (2.5-4.8) vs 2.7 (2.2-3.5), P = 0.002; Non-remitter: 0.014 (0.011-0.017) vs 0.011 (0.008-0.015), P = 0.03]. In multiple logistic regression, high NPR (≥ 0.014) remained independently associated with ECT non-response/non-remission after adjusting for confounding factors [Non-responder: OR = 4.911, 95% CI (2.052 - 11.754), P < 0.001; Non-remitter: OR = 2.704, 95% CI (1.262 - 5.796), P = 0.011].
Conclusion: High NPR correlates with poor ECT efficacy in adolescents with MDD, particularly among female and overweight patients.
Keywords: adolescents; electroconvulsive therapy; major depressive disorder; neutrophil-to-platelet ratio; response.
The article is available from the publisher here:
And from the text:
We are certainly hearing a lot about the immune system in depression these days. Whether on not the neutrophil-to-platelet ratio will turn out to be a useful marker for ECT response remains to be seen. It is difficult for me to judge the quality and veracity of the data in this report.
Certainly the number of adolescents reportedly treated with ECT in China is huge; it is not clear if this use is in line with treatment practice in the US and other countries.
I would be glad to have comments from blog readers, thanks.
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