Divergent lymphocyte associations with depression severity and case status in first-episode, drug-naive adolescents: A multicenter study

doi:10.5498/wjp.119439

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Jul 19, 2026; 16(7): 119439
Published online Jul 19, 2026. doi: 10.5498/wjp.119439

Table 1 Social demographic characteristics and immune markers across subgroups with different degrees of depression severity, n (%)/mean ± SD/median (interquartile rage)

Variables	Severity of depression			Total	H/χ²	P value
Variables	Mild	Moderate	Severe	Total	H/χ²	P value
Total	279 (13.19)	588 (27.80)	1248 (59.01)	2115 (100)
Age	16.22 ± 1.74	16.05 ± 1.72	15.75 ± 1.78	15.90 ± 1.77	25.95	< 0.001
Sex					112.06	< 0.001
Male	169 (21.86)	248 (32.08)	356 (46.06)	773 (36.55)
Female	110 (8.20)	340 (25.33)	892 (66.47)	1342 (63.45)
Area					2.43	0.297
Guangxi municipality	7 (10.14)	16 (23.19)	46 (66.67)	69 (3.26)
Jiangxi province	268 (13.74)	549 (28.14)	1134 (58.12)	1951 (92.25)
Shanghai province	4 (4.21)	23 (24.21)	68 (71.58)	95 (4.49)
WBC (× 10⁹/L)	6.58 (5.76-7.96)	7.03 (5.98-8.22)	6.98 (6.03-8.18)	6.95 (5.98-8.17)	9.31	0.009
Neutrophils (× 10⁹/L)	4.23 (3.40-5.28)	4.42 (3.46-5.89)	4.42 (3.46-5.75)	4.38 (3.46-5.76)	4.99	0.082
Lymphocytes (× 10⁹/L)	2.08 (1.61-2.70)	2.25 (1.68-2.80)	2.26 (1.71-2.88)	2.23 (1.68-2.84)	8.85	0.011
Monocytes (× 10⁹/L)	0.58 (0.51-0.68)	0.59 (0.52-0.68)	0.58 (0.51-0.67)	0.58 (0.51-0.68)	1.15	0.563
LNR	0.49 (0.35-0.70)	0.51 (0.35-0.70)	0.52 (0.36-0.72)	0.51 (0.36-0.71)	1.51	0.469
NMR	7.16 (5.76-9.08)	7.66 (5.94-9.51)	7.54 (5.96-9.46)	7.52 (5.94-9.44)	5.99	0.049
LMR	3.61 (2.66-4.40)	3.76 (2.92-4.83)	3.87 (3.00-4.90)	3.78 (2.92-4.83)	11.31	0.003

WBC: White blood cell; LNR: Lymphocyte-to-neutrophil ratio; NMR: Neutrophil-to-monocyte ratio; LMR: Lymphocyte-to-monocyte ratio.

Full Size Table

Table 2 Social demographic and clinical immunological characteristics of each group, n (%)/mean ± SD/median (interquartile rage)

Variables	Depression		Total	t/χ²/Z	P value
Variables	No	Yes	Total	t/χ²/Z	P value
Total	41 (50)	41 (50)	82 (100)
Age	15.29 ± 2.33	15.00 ± 2.06	15.15 ± 2.19	0.25	0.619
Sex				1.92	0.165
Male	18 (62.07)	11 (37.93)	29 (41.54)
Female	23 (43.40)	30 (56.60)	53 (58.46)
WBC (× 10⁹/L)	7.47 (1.60)	6.55 (1.45)	7.01 (1.59)	2.73	0.007
Neutrophils (× 10⁹/L)	4.57 (3.44-5.32)	3.32 (2.46-4.51)	3.80 (2.76-4.84)	2.79	0.005
Lymphocytes (× 10⁹/L)	2.96 (2.25-3.92)	2.37 (1.99-2.89)	2.64 (2.14-3.05)	2.97	0.002
Monocytes (× 10⁹/L)	0.45 (0.13)	0.44 (0.11)	0.45 (0.12)	0.46	0.647
LNR	0.68 (0.49-0.86)	0.78 (0.53-1.00)	0.71 (0.51-0.94)	0.57	0.568
NMR	10.12 (7.91-11.89)	7.82 (6.18-9.45)	8.50 (6.74-10.66)	2.50	0.012
LMR	6.41 (5.49-8.24)	5.66 (4.42-6.97)	6.10 (4.71-7.48)	2.01	0.044

WBC: White blood cell; LNR: Lymphocyte-to-neutrophil ratio; NMR: Neutrophil-to-monocyte ratio; LMR: Lymphocyte-to-monocyte ratio.

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Table 3 Relationship between immunological markers and depression in adolescents with major depressive disorder

Variables	Model 1				Model 2
Variables	B	SE	OR (95%CI)	P value	B	SE	OR (95%CI)	P value
Neutrophils (× 10⁹/L)	-0.4	0.2	0.64 (0.46-0.89)	0.008	-0.5	0.2	0.62 (0.44-0.87)	0.006
Lymphocytes (× 10⁹/L)	-1.0	0.3	0.36 (0.19-0.69)	0.002	-1.3	0.4	0.27 (0.13-0.57)	< 0.001
Monocytes (× 10⁹/L)	-0.9	1.9	0.41 (0.01-17.31)	0.642	-0.5	2.0	0.61 (0.01-29.12)	0.800
LNR	0.1	0.7	1.09 (0.29-4.03)	0.897	-0.1	0.7	0.93 (0.24-3.59)	0.921
NMR	-0.2	0.1	0.83 (0.71-0.98)	0.022	-0.2	0.1	0.82 (0.70-0.96)	0.015
LMR	-0.2	0.1	0.79 (0.63-0.98)	0.034	-0.3	0.1	0.72 (0.56-0.92)	0.009

Model 1 was unadjusted, and model 2 was adjusted for age and sex. LNR: Lymphocyte-to-neutrophil ratio; NMR: Neutrophil-to-monocyte ratio; LMR: Lymphocyte-to-monocyte ratio; OR: Odds ratio; CI: Confidence interval.

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Table 4 Immune marker differences across adolescence stages in depressed individuals

Variables	Early adolescence (n = 226)		Middle adolescence (n = 1492)		Late adolescence (n = 397)
Variables	OR (95%CI)	P value	OR (95%CI)	P value	OR (95%CI)	P value
Neutrophils (× 10⁹/L)	1.07 (0.92-1.24)	0.36	0.99(0.94-1.05)	0.86	1.04 (0.94-1.14)	0.45
Lymphocytes (× 10⁹/L)	1.08 (0.80-1.46)	0.59	1.13 (1.01-1.27)	0.03	1.09 (0.89-1.32)	0.38
Monocytes (× 10⁹/L)	1.74 (0.27-11.34)	0.56	0.78 (0.38-1.61)	0.50	1.08 (0.34-3.40)	0.89
LNR	0.90 (0.43-1.88)	0.78	1.25 (0.89-1.78)	0.19	1.20 (0.72-2.00)	0.47
NMR	1.04 (0.94-1.16)	0.41	1.01 (0.98-1.04)	0.51	1.04 (0.98-1.10)	0.24
LMR	1.04 (0.87-1.24)	0.62	1.09 (1.02-1.17)	0.01	1.07 (0.95-1.22)	0.26

Early adolescence (10-13 years), middle adolescence (14-17 years), and late adolescence (18-19 years). Model was adjusted for sex. LNR: Lymphocyte-to-neutrophil ratio; NMR: Neutrophil-to-monocyte ratio; LMR: Lymphocyte-to-monocyte ratio; OR: Odds ratio; CI: Confidence interval.

Full Size Table

Citation: Fan XW, Hou JZ, Wang YZ, Gao ML, Shen Y, Jian D, Zhou Q, Yang J, Zhao H, Zhang LJ. Divergent lymphocyte associations with depression severity and case status in first-episode, drug-naive adolescents: A multicenter study. World J Psychiatry 2026; 16(7): 119439
URL: https://www.wjgnet.com/2220-3206/full/v16/i7/119439.htm
DOI: https://dx.doi.org/10.5498/wjp.119439

Fan XW, Hou JZ, Wang YZ, Gao ML, Shen Y, Jian D, Zhou Q, Yang J, Zhao H, Zhang LJ. Divergent lymphocyte associations with depression severity and case status in first-episode, drug-naive adolescents: A multicenter study. World J Psychiatry 2026; 16(7): 119439 [DOI: 10.5498/wjp.119439]

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