Mean corpuscular hemoglobin The results showed that mean white blood cell count WBC of depressed patients was 7.46 G/L, while in healthy people it was 6.86 G/L.. There was a statistical
Trang 1A STUDY ON THE CHANGES OF COMPLETE BLOOD COUNT
IN DEPRESSION PATIENTS
Pham Thi Thu 1 , Le Van Quang 2 , Nguyen Tat Dinh 3
SUMMARY
Objectives: To study the changes in some complete blood count indexes in depressed
patients Subjects and methods: Descriptive retrospective study Case group: 138 depressed
patients were treated in the Psychiatric Department, Military Hospital 103, discharged from January 1 st , 2019 to December 31 st , 2019 Control group: 164 healthy people giving from kidney donors at the Urology Department, Military Hospital 103 were discharged from January 1 st ,
2019 to June 30 th , 2020 Data were analyzed by SPSS 20 Results and conclusions: Among
depressed patients, there was an increase in the number of leukocytes, neutrophils and monocytes,
a decrease in the number of erythrocytes and hemoglobin (p < 0.05) Mean corpuscular volume and mean corpuscular hemoglobin was higher in the study group compared to the control group Meanwhile mean corpuscular hemoglobin concentration was lower than that in the control group Red cell distribution width in the case group was statistically higher than that in the control group (p < 0.05) The number and volume of platelets in depressed patients was smaller than in healthy people, statistical significance (p < 0.05)
* Keywords: Depression; Complete blood count
INTRODUCTION
Depression is a common chronic disease
in the world, and associated with a wide
range of impairment and secondary
morbidity [1] Today, there are many
studies on the pathogenesis of depressive
disorders in addition to the role of genes
and neurotransmitters, including the role
of inflammation Many studies show an
association between depression and
inflammatory factors such as cortisol,
CRP, interleukin, white blood cell count
[2] Several indicators of complete blood
count are important factors in the evaluation of inflammatory processes Some studies show an increase in the number of leukocytes and neutrophils,
a decrease in the percentage of lymphocytes in depressed patients [3, 4, 5]
In addition, there are the changes in other indexes of complete blood count in depression In Vietnam, there have not been any studies on this issue Therefore,
we carried out this study aiming: To study
the changes in some complete blood count indexes in depressed patients
1 Department of Psychiatry, Military Hospital 103, Vietnam Military Medical University
2 Naval Commando Brigade 126
3 Department of Psychiatry, Military Hospital 103, Vietnam Military Medical University
Corresponding author: Pham Thi Thu (thu41b@gmail.com)
Date received: 24/11/2020
Date accepted: 27/01/2021
Trang 2SUBJECTS AND METHODS
1 Subjects
- Case group: 138 depressed patients
treated in the Psychiatric Department of
Military Hospital 103 were discharged
from January 1st, 2019 to December 31st,
2019
+ Diagnosis of depression: According
to ICD 10 diagnotic criteria
+ Exclusion criteria: Patients with
combined severe somatic disease and
patients with white blood cell counts
above 10 G/L
- Control group: 164 healthy people giving kidney donors at the Urology Department of Military Hospital 103 were discharged from January 1st, 2019 to June
30th, 2020
2 Methods
* Study design: Descriptive retrospective
study
Complete blood count were tested by machine in the Hematology Department, Military Hospital 103 Venous blood had been taken after one day since patient was admitted to the hospital
* Data analysis: By SPSS 20.0 version
RESULTS AND DISCUSSION
1 Gender and age group
Table 1: Gender and age group
Gender
Age
> 0.05
The results showed that 60.1% of patients in the case group were male, this rate
in the control group was 61.0% Subjects in both groups were mainly less than
30 years old (47.8% in the case group and 45.7% in the control group) and from 31
to 50 years old
There were no statistically significant differences in gender and age between the case group and the control group (p > 0.05) In general population, depression was more common in women than in men (female/male ratio: 2/1) [1], however at Military Hospital 103, the majority of patients were military personnel, thus most of them were male and young, which was consistent with the gender and age group of donors
Trang 32 The blood cell count indexes
Table 2: The blood cell count indexes
Mean corpuscular hemoglobin
The results showed that mean white
blood cell count (WBC) of depressed
patients was 7.46 G/L, while in healthy
people it was 6.86 G/L There was a
statistically significant higher number of
leukocytes among depressed patients
than healthy people (p < 0.05) The
number and percentage of neutrophils (N
and N%) in the case group was also
significantly higher than in the control
group (p < 0.05) The number of
lymphocytes (L) in two groups was not
statistically significant different, but the
percentage of lymphocytes (L%) in the
case group was statistically significant
lower than in control group (p < 0.05),
this was due to the fact that the increase
in the percentage of neutrophils reduces
the percentage of lymphocytes Similarly, the number of monocytes in the case group was significantly higher than in the control group (p < 0.05) but the increase
in the percentage was not statistically significant due to the greater increase in neutrophils This result is consistent with other findings [3, 4, 5] The white blood cell count is an important factor in the inflammatory evaluation According to the study by Demir S et al, in depressed patients there was an increase in the number of leukocytes and neutrophils, a decrease in the percentage of lymphocytes, but the number of lymphocytes did not have a statistically significant change compared with control group [4] A study
by Maes et al (1992) on 22 healthy people
Trang 4and 109 depressed patients found that
there was a significant increase in
leukocytes, neutrophils and monocytes in
depressed patients In addition, the number
of leukocytes, neutrophils, monocytes
was linearly associated with the severity
of depression [5]
Regarding the indexes of erythrocytes,
the results showed that the number of
erythrocytes and hemoglobin was
significantly lower in depressed patients
than in the control group (p < 0.05),
but no statistically significant difference
was found on hematocrit The mean
corpuscular volume and mean corpuscular
hemoglobin in the case group were
statistically higher than the control group
(p < 0.05), but the mean corpuscular
hemoglobin concentration in the case
group was lower than the control group
(p < 0.05) The indexes of mean
corpuscular volume, mean corpuscular
hemoglobin, mean corpuscular hemoglobin
concentration in both two groups were
within the normal range Vandoolaeghe E
et al conducted a study on 47 depressed
patients and 32 healthy people also found
that depressed patients had a statistically
significantly lower number of erythrocytes
than healthy people Hemoglobin and
hematocrit were also lower in the patient
group, but there was no difference in
mean corpuscular volume and mean
corpuscular hemoglobin According to the
author, this change was due to an
inflammatory response rather than a
deficiency of iron since the mean corpuscular
volume and mean corpuscular hemoglobin
did not decrease [3] According to Nemeth
E et al, inflammatory factors reduce
erythrocytes life, so the number of
erythrocytes in patients with inflammatory
processes is lower than in healthy group [6] Our results show that the red cell distribution width in the case group is statistically higher than the control group Red cell distribution width is the test to evaluate the change in the size and shape of red blood cells A study by Liqiang in 2017 also found that depressed patients had a higher red cell distribution width than healthy people [7]
Regarding the platelet indexes, the results showed that in the case group, the number of platelet as well as the mean platelet volume was significantly lower than the control group (p < 0.05) Platelets are a source of serotonin, a disruption of the serotonin system plays
an important role in the pathogenesis of depressive disorders In addition, platelets are variants in the inflammatory process The study by Liqiang also found that the case group had a statistically significantly larger platelet volume but found no statistically significant difference in platelet count The authors suggest that mean platelet volume may be useful marker of inflammation in depression [7] However, according to Sonmez, during the inflammatory process, activated platelets will stick to the white blood cells, focus on the inflammation site and aggregate, so that the number of platelets
in circulation can decrease [8] Several studies of platelet volume in chronic inflammatory diseases such as chronic periodontitis found that the mean platelet volume in the patient group was statistically significantly smaller than the control group [9] The author believes that large activated platelets have been aggregated and sticked, the rest of the platelets circulating in the blood had small
Trang 5size In addition, megakaryocytes in the
bone marrow is interfered by inflammatory
factors, resulting in produced small
platelets [9] A study on panic disorder
patients by Gul IG et al also found that the
patients with panic disorder had a smaller
platelet size than the control group The
authors suggest that abnormal serotonin
metabolism may lead to a decrease in
platelet size [10]
CONCLUSION
Through this study, we found that
many indicators of complete blood count
vary in patients with depressive disorder,
reflecting the association between
depressive disorders and inflammation In
particular, there was a statistically
significant increase in the number of
leukocytes, neutrophils and monocytes, a
decrease in the number of red blood cells
and hemoglobin among depressed patients
(p < 0.05)
Depressed patients had a higher mean
corpuscular volume and mean corpuscular
hemoglobin than the control group, mean
corpuscular hemoglobin concentration was
lower than the control group (p < 0.05)
Red cell distribution width in the case
group was statistically higher than the
control group (p < 0.05)
The number and volume of platelets in
depressed patients was significantly
smaller than in healthy people (p < 0.05)
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