Abstract
Objective
To investigate the discriminative value of the combination of lymphocyte-to-high-density lipoprotein ratio (LHR), neutrophil-to-lymphocyte ratio (NLR), and platelet count for patients with first-episode schizophrenia (FES).Methods
A retrospective analysis was performed on 181 antipsychotic-naïve inpatients with FES admitted to Zhenjiang Mental Health Center between January 2015 and February 2025.189 participants, including staff members who underwent health check-ups at the same center from July 2024 to November 2025, were prospectively recruited as the healthy control group. Both groups underwent fasting blood cell analysis. Univariate analysis, binary Logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were employed to assess the diagnostic performance of the combined use of LHR, NLR, and platelet count for FES.Results
Univariate analysis revealed that white blood cell count, neutrophil count, monocyte count, platelet count, high-density lipoprotein (HDL), neutrophil-to-high-density lipoprotein ratio (NHR), LHR, platelet-to-lymphocyte ratio (PLR), NLR, and systemic immune-inflammation index (SIRI) were statistically significant influencing factors associated with FES (all P Conclusion
The combination of LHR, NLR, and platelet count is significantly elevated in antipsychotic-naïve FES patients compared with healthy controls. These findings highlight immune-metabolic dysregulation in acute-phase FES, but do not establish diagnostic specificity. Comparative studies with other acute psychiatric disorders are needed.