Neutrophil-Lymphocyte Ratio as a Potential Biomarker for Schizophrenia Severity: A Cross-Sectional Study

BACKGROUND: Schizophrenia is a chronic psychiatric disorder with a complex etiology, and inflammation has been increasingly implicated in its pathophysiology. The neutrophil-lymphocyte ratio (NLR), a simple hematological marker, may serve as an adjunctive biomarker for disease severity. OBJECTIVE: To evaluate the association between NLR and schizophrenia severity, and to compare inflammatory status between treated and untreated patients. METHODS: A hospital-based cross-sectional study was conducted among 100 patients with International Classification of Diseases, Tenth Revision (ICD-10)-diagnosed schizophrenia. Of 143 patients screened, 43 were excluded. Symptom severity was assessed using the Brief Psychiatric Rating Scale (BPRS). Complete blood counts were analyzed to calculate NLR. Statistical analysis included Welch's t-test, chi-square test, and Pearson's correlation (α = 0.05). RESULTS: The mean age of participants was 47.9 ± 8.6 years; 73% were male. Fifty-nine patients were treated, and 41 were untreated. Untreated patients had significantly higher NLR values (8.94 ± 5.08 vs. 4.57 ± 1.90; p < 0.001). The mean BPRS score was 61.9 ± 17.3. NLR correlated strongly with BPRS (r = 0.736, p < 0.001). CONCLUSION: Elevated NLR is associated with greater schizophrenia severity and higher values in untreated patients. NLR, being inexpensive and widely available, could serve as an adjunctive tool for routine monitoring and personalized management.