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October 8, 2025BMC Psychiatry3 citationsOpen Access

Assessing the relationship between suicidality and inflammatory biomarkers: C-reactive protein/albumin and neutrophil/albumin ratios in an inpatient setting

RERümeysa Yeni ElbaySESeda Sarıkaya ErdilAİAyşegül İlhan

Key Result

Inflammatory biomarkers, including C-reactive protein-to-albumin and neutrophil-to-albumin ratios, showed no statistically significant differences between female psychiatric inpatients with and without suicidality.

Study Design

Type

Cross-Sectional (n=221)

Multicenter

No

Structured PICO

P
Population
221 female psychiatric inpatients aged 18-65 years admitted to a single center in Turkey. Excluded: intellectual disability, dementia, elevated WBC from bacterial infection, systemic conditions affecting inflammatory status (diabetes, liver/kidney failure, hypertension, acute infection, immune-inflammatory diseases, pregnancy), and use of anti-inflammatory/immunosuppressive medications.
O
Outcome
Differences in inflammatory biomarkers (MPV, RDW, NLR, MLR, PLR, CAR, NAR) between patients with and without suicidalitysurrogate

Inflammatory biomarkers such as CAR, NAR, NLR, and PLR may not be robust indicators of suicidality in female psychiatric inpatients.

Main Result

Absolute Event Rate: 0.09% vs 0.11%

p-value: p=0.264

Limitations

  • Included only inpatients, limiting generalizability
  • Female-only sample with a relatively small sample size
  • Did not control for the effects of pharmacological treatments
  • Did not separate suicide attempts from suicide ideation
  • Potential confounding factors such as age, BMI, smoking/alcohol use, and psychosocial stressors were not assessed
  • Female-only sample
  • Relatively small sample size
  • Did not separate suicide attempt and ideation
  • Potential confounding factors (age, BMI, diagnosis, smoking/alcohol use, psychotropic medications, psychosocial stressors) were not assessed

Abstract

BACKGROUND: Suicidality is a significant public health concern with multifactorial etiologies, including psychological, environmental, and biological factors. Emerging evidence suggests a strong association between inflammatory processes and suicidality. This study aims to investigate the relationship between suicidality and inflammatory biomarkers in psychiatric inpatients. METHODS: This retrospective cross-sectional study included female psychiatric inpatients aged 18-65 years admitted to the Psychiatry Department of Goztepe Prof. Dr. Suleyman Yalcin City Hospital between 2022 and 2024. Inflammatory biomarkers, including C-reactive protein (CRP), albumin, neutrophils, lymphocytes, monocytes, platelets, and red cell distribution width (RDW), mean platelet volume (MPV) were analyzed. Additionally, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), CRP-to-albumin ratio (CAR), and neutrophil-to-albumin ratio (NAR) were calculated. RESULTS: The analysis revealed no statistically significant differences between patients with suicidality (including both suicide ideation and history of suicide attempts) and the non-suicidality group in terms of MPV, RDW, NLR, MLR, PLR, CAR or NAR values, with all parameters showing p > 0.05. CONCLUSIONS: The absence of statistically significant differences in inflammatory markers suggests that these biomarkers may not be robust indicators of suicidality in this sample. Further research with larger, more diverse populations is warranted to clarify the potential role of inflammation in suicidality.

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Cite This Study

Elbay et al. (2025) conducted a cross-sectional in Psychiatric disorders (n=221). Suicidality (suicide ideation and history of suicide attempts) vs. No suicidality was evaluated on C-reactive protein-to-albumin ratio (CAR) (p=0.264). Inflammatory biomarkers, including C-reactive protein-to-albumin and neutrophil-to-albumin ratios, showed no statistically significant differences between female psychiatric inpatients with and without suicidality.

synapsesocial.com/papers/6a12d1f945487b7639a7381chttps://doi.org/10.1186/s12888-025-07416-9
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