Evaluation of haematological parameters in patients with first-episode psychosis: distinctions between bipolar disorder and schizophrenia spectrum disorders

BACKGROUND: Differences in blood cells and inflammatory markers occur during the first psychosis episode. Our study compared blood cell counts and inflammation markers among bipolar disorder, schizophrenia spectrum and healthy controls. METHODS: The study involved 55 patients with schizophrenia spectrum disorders and 68 with bipolar disorder with psychotic features (manic episode), all hospitalised for a first psychotic episode with no prior psychiatric treatment, along with 61 age- and sex-matched healthy controls. Hemogram data from medical records were used, specifically those obtained within the first 48 h of hospitalisation. RESULTS: Both patient groups had higher white blood cell, neutrophil, and monocyte counts than healthy controls. Patients with bipolar disorder had lower red blood cell counts, while schizophrenia patients showed lower eosinophil levels. Both groups also had elevated monocyte-to-lymphocyte ratios (MLR) compared to controls. No significant differences in blood cell counts or inflammatory markers were found between bipolar disorder and schizophrenia spectrum groups. CONCLUSIONS: Subtle Immune changes, including elevated MLR, monocytes and neutrophils, are observed in first-episode psychosis patients with bipolar disorder and schizophrenia spectrum diagnoses. Condition-specific findings, like decreased RBCs in bipolar disorder and eosinophils in schizophrenia, suggest unique early haematological profiles. These indicate low-grade inflammation may contribute to early psychotic disorders and underline the need for more longitudinal research.