Clinical symptom improvement following modified electroconvulsive therapy is associated with modulation of peripheral inflammatory markers in schizophrenia

Table 1 Characteristics of the study participants (n = 619), n (%)

Characteristic	Value
Age, years, mean ± SD	36.03 ± 10.69
Male	323 (52.18)
Female	296 (47.82)
Illness duration, years, mean ± SD	9.24 ± 8.15
Baseline PANSS total score, mean ± SD	94.85 ± 14.02
Atypical antipsychotics	587 (94.83)
Typical antipsychotics	32 (5.17)

PANSS: Positive and Negative Syndrome Scale.

Table 2 Comparison of Positive and Negative Syndrome Scale scores and inflammatory markers

	Before MECT	After MECT	Statistical analysis
	mean ± SD	mean ± SD	Z	P value
PANSS	94.85 (14.02)	57.05 (12.89)	21.557	< 0.001
MLR	0.30 (0.20)	0.24 (0.18)	8.486	< 0.001
NLR	3.42 (2.27)	2.59 (2.23)	10.089	< 0.001
PLR	161.67 (116.03)	167.59 (124.73)	3.303	< 0.001
SII	763.01 (595.37)	586.36 (470.14)	8.291	< 0.001

MECT: Modified electroconvulsive therapy; PANSS: Positive and Negative Syndrome Scale; MLR: Monocyte-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; SII: Systemic immune-inflammatory index.

Table 3 Logistic regression analysis of inflammatory marker changes as predictors of clinical symptom improvement after modified electroconvulsive therapy

	Increment	OR	95%CI	P value
ΔMLR	per 0.1 unit	1.572	1.300-1.900	< 0.001
ΔNLR	per 0.1 unit	1.044	1.026-1.062	< 0.001
ΔSII	per 10 unit	1.010	1.005-1.015	< 0.001

OR: Odds ratio; CI: Confidence interval; MLR: Monocyte-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; SII: Systemic immune-inflammatory index.