Abstract
BACKGROUND: More and more evidence shows that infection and immune abnormality are closely related to the increased severity of schizophrenia symptoms. This study aimed to explore the correlation between inflammatory cell counts, sleep quality, and psychiatric symptoms in first-episode schizophrenia patients. METHODS: A total of 103 first-episode schizophrenia patients (patient group) admitted to the Anhui Provincial Mental Health Center from November 2021 to August 2022 were included in the study, while 57 healthy individuals (control group) who met the criteria were recruited as the study subjects. The Positive and Negative Symptom Scale (PANSS) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the mental symptoms and sleep status of the patients. Blood analysis results were used to determine the peripheral blood white blood cells (WBC) and lymphocytes of the two groups. Count neutrophils, monocytes, and platelets (PLT) of the two groups. The neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR) were calculated. Differential, correlation, and regression analysis were performed on survey data using SPSS 26.0. RESULTS: Results showed WBC, neutrophils, monocytes, NLR, MLR higher in case vs control group (p<0.05). Correlation analysis found monocytes negatively correlated with sleep time (rs=-0.205, p=0.037) and MLR with arousal factor (rs=-0.204, p=0.039). Linear regression showed that MLR positively affected arousal score (B=7.196, t=2.781, p=0.006) and monocytes negatively affected sleep time score (B=-0.851, t=-2.157, p=0.033). ROC analysis revealed high sensitivity and specificity of WBC, neutrophils, monocytes, NLR, MLR for SCZ symptom prediction. CONCLUSION: The study concluded that elevated WBC, neutrophils, monocytes, NLR, and MLR levels in the case group were significantly associated with increased severity of schizophrenia symptoms, particularly affecting sleep and arousal factors, and demonstrated high predictive validity for SCZ symptoms.