Abstract
Background
Systemic inflammatory and nutritional indices derived from hematological parameters have emerged as accessible markers of immune imbalance. Although these indices have been investigated across various medical disciplines, their roles in psychiatric patients with positive urinary drug metabolites have not yet been reported. This study aimed to compare hematological inflammation and nutritional indices between psychiatric patients with positive urinary drug metabolites and healthy controls, to evaluate the Systemic Inflammation Response Index (SIRI), Systemic Immune-Inflammation Index (SII), and Prognostic Nutritional Index (PNI), explore their variations across substance types and usage patterns, and determine their association with immune-nutritional dysregulation.Methods
This retrospective study included 760 psychiatric inpatients with positive urinary drug metabolites, 171 psychiatric patients without positive metabolites, and 151 healthy controls treated at X City Hospital between 2022 and 2024. SIRI, SII, and PNI were calculated from hematological and/or biochemical parameters. Patients with infectious, autoimmune, or malignant diseases or incomplete data were excluded. Group comparisons, age- and sex-adjusted regression analyses, multiple-comparison corrections, and ROC analyses were performed.Results
Patients had higher SIRI [1.24 (0.79-1.97) vs. 0.98 (0.74-1.27)] and lower PNI (56.0 ± 6.12 vs. 58.8 ± 3.87) than controls (both p Conclusion
Differences in SIRI and PNI were observed between psychiatric patients and healthy controls. However, these differences were not consistent across diagnostic and substance-use subgroups, and some associations were attenuated after adjustment for age and sex. These findings indicate variability in inflammatory and immunonutritional indices across psychiatric and substance-use subgroups and warrant further investigation.