Research Article
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Evaluation of systemic immune-inflammation index, systemic inflammatory response index and hematologic inflammatory parameters in generalized anxiety disorder: a controlled study

Year 2024, Volume: 6 Issue: 2, 161 - 167, 08.03.2024

Derya Canlı

https://doi.org/10.38053/acmj.1427475

Abstract

Aims: The current study aimed to examine the values of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) in generalized anxiety disorder (GAD).
Methods: In this retrospective study, 147 GAD patients who did not receive treatment and 154 healthy controls with similar characteristics to the patient group were included. NLR, PLR, MLR, SII, and SIRI values calculated from the complete blood count values of the GAD group were compared with age- and sex-matched healthy controls.
Results: Neutrophil, lymphocyte, monocyte, platelet counts and NLR, MLR, SII, and SIRI values were significantly higher in the GAD group compared to healthy controls (p<0.001, p=0.001, p<0.001, p<0.001, p<0.001, p=0.003, p<0.001, p<0.001, respectively). The logistic regression analysis revealed that SII and SIRI were identified as significant variables associated with receiving a diagnosis of GAD.
Conclusion: Inflammatory markers such as NLR, MLR, SII, and SIRI are thought to play an important role in the evaluation of inflammatory activity in GAD. However, larger and more comprehensive studies are needed.

Keywords

Generalized anxiety disorder inflammatory biomarker systemic immune-inflammation index systemic inflammatory response index

References

  • Gündüz A. Yaygın anksiyete bozukluğunda bilişsel davranışçı terapiler. In: Bahadır G, Ertekin E, eds. Farklı tanı gruplarında bilişsel davranışçı terapiler. Klinikleri: 2019:28-34.
  • Costello H, Gould RL, Abrol E, Howard R. Systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalized anxiety disorder. BMJ Open. 2019;9(7):e027925.
  • Najjar S, Pearlman DM, Alper K, Najjar A, Devinsky O. Neuroinflammation and psychiatric illness. J Neuroinflammation. 2013;10(1):43.
  • Bauer ME, Teixeira AL. Inflammation in psychiatric disorders: what comes first? Ann N Y Acad Sci. 2019;1437(1):57-67.
  • Özdin S, Sarisoy G, Böke Ö. A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients - a retrospective file review. Nord J Psychiatry. 2017;71(7):509-512.
  • Fest J, Ruiter R, Ikram MA, Voortman T, vanEijck CHJ, Stricker BH. Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study. Sci Rep. 2018;8(1):10566.
  • Ransing RS, Gupta N, Agrawal G, Mahapatro N. Platelet and red blood cell indices in patients with panic disorder: a receiver operating characteristic analysis. J Neurosci Rural Pract. 2020;11(2):261-266.
  • Örüm M. Comparison of complete blood count parameters of panic attack and panic disorder. Med Sci. 2021;10(1):125-131.
  • Wang JL, Lu XY, Xu XH, et al. Predictive role of monocyte-to-lymphocyte ratio in patients with Klebsiella pneumonia infection: a single-center experience. Medicine. 2019;98(38):e17215.
  • Öztürk S, Başaran A, Erdoğan M, Turan Y. Association of left ventricular ejection fraction with inflammation parameters and indexes. J Tepecik Educ Res Hosp. 2022;32(3):439-447.
  • Ozturk HM, Ozturk S, Yetkin E. Linkage between cardiovascular diseases and major depression: contribution of platelet cells. Psychiatry Res. 2020;287:111026.
  • Feng Y, Zhang N, Wang S, et al. Systemic ınflammation response ındex ıs a predictor of poor survival in locally advanced nasopharyngeal carcinoma: a propensity score matching study. Front Oncol. 2020;10:575417.
  • Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest. 2020;50(5):e13230.
  • Bulut NS, Yorguner N, Çarkaxhiu Bulut G. The severity of inflammation in major neuropsychiatric disorders: comparison of neutrophil-lymphocyte and platelet-lymphocyte ratios between schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and obsessive compulsive disorder. Nord J Psychiatry. 2021;75(8):624-632.
  • Rodríguez JO, Fernández JD, Mira NO, López-Briz E, Gómez-Pajares F. Neutrophil/lymphocyte ratio: can a non-specific marker of inflammation helps to confirm the inflammatory hypothesis of the serious mental diseases? A case-control study. Med Hypotheses. 2019;130:109279.
  • Kulacaoglu F, Yıldırım YE, Aslan M, İzci F. Neutrophil to lymphocyte and monocyte to high-density lipoprotein ratios are promising inflammatory indicators of bipolar disorder. Nord J Psychiatry. 2023;77(1):77-82.
  • Demir B, Kocamer Şahin Ş, Özsoy F, Altındağ A, Elboga G. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in methamphetamine use disorder. Psychiatr Clin Psychopharmaco. 2021;31(1):34-39.
  • Herdi O, Sayar-Akaslan D, İlhan RS, Çolak B, Duman B. Associations between subclinical inflammatory markers and OCD: a retrospective study. Psychiatry Res. 2020;290:113065.
  • Gündüz N, Timur O, Erzincan E, Tural U. The mean platelet volume, neutrophil lymphocyte ratio, platelet lymphocyte ratio and red cell distribution width in panic disorder. Anadolu Psikiyatri Derg. 2018;19(1):5-12.
  • Rosales C. Neutrophil: a cell with many roles in inflammation or several cell types? Front Physiol. 2018;9:113.
  • Canpolat U, Çetin EH, Cetin S, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost. 2016;22(5):476-482.
  • Yalcin K, Tahtacı G, Balcık O. Role of platelets in inflammation. Dicle Tip Derg. 2012;39(3):455-457.
  • Wei Y, Wang T, Li G, et al. Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder. Front Psychiatry. 2022;13:941728.
  • Vogelzangs N, Beekman AT, de Jonge P, Penninx BW. Anxiety disorders and inflammation in a large adult cohort. Transl Psychiatry. 2013;3(4):e249.
  • Hou R, Garner M, Holmes C, et al. Peripheral inflammatory cytokines and immune balance in generalised anxiety disorder: case-controlled study. Brain Behav Immun. 2017;62:212-218.
  • Heidt T, Sager HB, Courties G, et al. Chronic variable stress activates hematopoietic stem cells. Nat Med. 2014;20(7):754-758.
  • Bhikram T, Sandor P. Neutrophil-lymphocyte ratios as inflammatory biomarkers in psychiatric patients. Brain Behav Immun. 2022;105:237-246.
  • Lin BD, Hottenga JJ, Abdellaoui A, et al. Causes of variation in the neutrophil-lymphocyte and platelet-lymphocyte ratios: a twin-family study. Biomark Med. 2016;10(10):1061-1072.
  • Brinn A, Stone J. Neutrophil-lymphocyte ratio across psychiatric diagnoses: a cross-sectional study using electronic health records. BMJ Open. 2020;10(7):e036859.
  • Kok Kendirlioglu B, Arat Celik HE, Buyuksandalyaci Tunc AE, et al. Lymphocyte-related ratios, systemic immune-inflammatory and systemic inflammatory response index in alcohol use disorder. J Immunoassay Immunochem. 2024;45(1):38-49.
  • Unal Demir F, Ozsoy F, Akpınar Aslan E. Inflammation in chronic psychiatric patients: neutrophil/lymphocyte ratios, platelet/lymphocyte ratios, and mean platelet volume. KSU Med J. 2023;18(2):53-59.
  • Uzun N, Akıncı MA. Hemogram parameters in childhood anxiety disorders: could anxiety disorders be related with inflammation? Med Hypotheses. 2021;146:110440.
  • Amitai M, Kaffman S, Kroizer E, et al. Neutrophilto-lymphocyte and platelet-to-lymphocyte ratios as biomarkers for suicidal behavior in children and adolescents with depression or anxiety treated with selective serotonin reuptake inhibitors. Brain Behav Immun. 2022;104:31-38.
  • Gurok MG, Yılmaz S, Temizkan A, Ustundag B, Atmaca M. Levels of basophils and eosinophils are elevated while lymphocytes are reduced in patients with panic disorder compared to controls: a preliminary study. Psychiatr Clin Psychopharmacol. 2019;29(3):315-319.
  • Özyurt G, Binici NC. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in adolescent obsessive-compulsive disorder: does comorbid anxiety disorder affect inflammatory response? Psychiatry Res. 2019;272:311-315.
  • Öztürk S, Erdoğan M, Turan Y. Systemic immune-inflammation index and high-sensitivity cardiac troponin T in acute coronary syndromes. Acta Med Alanya. 2021;5(3):218-225.
  • Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic ımmune-ınflammation ındex (SII) can be an early indicator for predicting the severity of acute pancreatitis: a retrospective study. Int J Gen Med. 2021;14:9483-9489.
  • Zhou YX, Li WC, Xia SH, et al. Predictive value of the systemic immune inflammation index for adverse outcomes in patients with acute ischemic stroke. Front Neurol. 2022;13:836595.
  • Aziz MH, Sideras K, Aziz NA, et al. The systemic-immune-inflammation Index independently predicts survival and recurrence in resectable pancreatic cancer and its prognostic value depends on bilirubin levels: a retrospective multicenter cohort study. Ann Surg. 2019;270(1):139-146.
  • Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Part A):229-236.
  • Liu X, Bai X, Ren R, et al. Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: a cross-sectional study. Front Psychiatry. 2022;13:985823.
  • Dionisie V, Filip GA, Manea MC, et al. Neutrophil-to-lymphocyte ratio, a novel inflammatory marker, as a predictor of bipolar type in depressed patients: a quest for biological markers. J Clin Med. 2021;10(9):1924.
  • Inaltekin A, Yağci İ. Evaluation of simple markers of inflammation and systemic immune inflammation index in schizophrenia, bipolar disorder patients and healthy controls. Turk Psikiyatri Derg. 2023;34(1):11-15.
  • Mazza M, de Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors. Brain Behav Immun. 2020;89:594-600.
  • Huang K, Tang Y, Chen Z, et al. Comparison of hematological parameters between first-episode schizophrenia and anti-NMDAR encephalitis. Front Cell Dev Biol. 2022;10:895178.
  • Kadier K, Dilixiati D, Ainiwaer A, et al. Analysis of the relationship between sleep-related disorder and systemic immune-inflammation index in the US population. BMC Psychiatry. 2023;23(1):773.
  • Qi Q, Zhuang L, Shen Y, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer. 2016;122(14):2158-2167.
  • Wei L, Xie H, Yan P. Prognostic value of the systemic inflammation response index in human malignancy: a meta-analysis. Medicine. 2020;99(50):e23486.
  • Debnath M, Berk M, Maes M. Translational evidence for the inflammatory response system (IRS)/ compensatory immune response system (CIRS) and neuroprogression theory of major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2021;111:110343.
  • Murata S, Baig N, Decker K, Halaris A. Systemic inflammatory response index (SIRI) at baseline predicts clinical response for a subset of treatment-resistant bipolar depressed patients. J Pers Med. 2023;13(9):1408.
  • Li X, Huan J, Lin L, Hu Y. Association of systemic inflammatory biomarkers with depression risk: results from National Health and Nutrition Examination Survey 2005-2018 analyses. Front Psychiatry. 2023;14:1097196.

Year 2024, Volume: 6 Issue: 2, 161 - 167, 08.03.2024

Derya Canlı

https://doi.org/10.38053/acmj.1427475

Abstract

References

  • Gündüz A. Yaygın anksiyete bozukluğunda bilişsel davranışçı terapiler. In: Bahadır G, Ertekin E, eds. Farklı tanı gruplarında bilişsel davranışçı terapiler. Klinikleri: 2019:28-34.
  • Costello H, Gould RL, Abrol E, Howard R. Systematic review and meta-analysis of the association between peripheral inflammatory cytokines and generalized anxiety disorder. BMJ Open. 2019;9(7):e027925.
  • Najjar S, Pearlman DM, Alper K, Najjar A, Devinsky O. Neuroinflammation and psychiatric illness. J Neuroinflammation. 2013;10(1):43.
  • Bauer ME, Teixeira AL. Inflammation in psychiatric disorders: what comes first? Ann N Y Acad Sci. 2019;1437(1):57-67.
  • Özdin S, Sarisoy G, Böke Ö. A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients - a retrospective file review. Nord J Psychiatry. 2017;71(7):509-512.
  • Fest J, Ruiter R, Ikram MA, Voortman T, vanEijck CHJ, Stricker BH. Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study. Sci Rep. 2018;8(1):10566.
  • Ransing RS, Gupta N, Agrawal G, Mahapatro N. Platelet and red blood cell indices in patients with panic disorder: a receiver operating characteristic analysis. J Neurosci Rural Pract. 2020;11(2):261-266.
  • Örüm M. Comparison of complete blood count parameters of panic attack and panic disorder. Med Sci. 2021;10(1):125-131.
  • Wang JL, Lu XY, Xu XH, et al. Predictive role of monocyte-to-lymphocyte ratio in patients with Klebsiella pneumonia infection: a single-center experience. Medicine. 2019;98(38):e17215.
  • Öztürk S, Başaran A, Erdoğan M, Turan Y. Association of left ventricular ejection fraction with inflammation parameters and indexes. J Tepecik Educ Res Hosp. 2022;32(3):439-447.
  • Ozturk HM, Ozturk S, Yetkin E. Linkage between cardiovascular diseases and major depression: contribution of platelet cells. Psychiatry Res. 2020;287:111026.
  • Feng Y, Zhang N, Wang S, et al. Systemic ınflammation response ındex ıs a predictor of poor survival in locally advanced nasopharyngeal carcinoma: a propensity score matching study. Front Oncol. 2020;10:575417.
  • Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest. 2020;50(5):e13230.
  • Bulut NS, Yorguner N, Çarkaxhiu Bulut G. The severity of inflammation in major neuropsychiatric disorders: comparison of neutrophil-lymphocyte and platelet-lymphocyte ratios between schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and obsessive compulsive disorder. Nord J Psychiatry. 2021;75(8):624-632.
  • Rodríguez JO, Fernández JD, Mira NO, López-Briz E, Gómez-Pajares F. Neutrophil/lymphocyte ratio: can a non-specific marker of inflammation helps to confirm the inflammatory hypothesis of the serious mental diseases? A case-control study. Med Hypotheses. 2019;130:109279.
  • Kulacaoglu F, Yıldırım YE, Aslan M, İzci F. Neutrophil to lymphocyte and monocyte to high-density lipoprotein ratios are promising inflammatory indicators of bipolar disorder. Nord J Psychiatry. 2023;77(1):77-82.
  • Demir B, Kocamer Şahin Ş, Özsoy F, Altındağ A, Elboga G. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in methamphetamine use disorder. Psychiatr Clin Psychopharmaco. 2021;31(1):34-39.
  • Herdi O, Sayar-Akaslan D, İlhan RS, Çolak B, Duman B. Associations between subclinical inflammatory markers and OCD: a retrospective study. Psychiatry Res. 2020;290:113065.
  • Gündüz N, Timur O, Erzincan E, Tural U. The mean platelet volume, neutrophil lymphocyte ratio, platelet lymphocyte ratio and red cell distribution width in panic disorder. Anadolu Psikiyatri Derg. 2018;19(1):5-12.
  • Rosales C. Neutrophil: a cell with many roles in inflammation or several cell types? Front Physiol. 2018;9:113.
  • Canpolat U, Çetin EH, Cetin S, et al. Association of monocyte-to-HDL cholesterol ratio with slow coronary flow is linked to systemic inflammation. Clin Appl Thromb Hemost. 2016;22(5):476-482.
  • Yalcin K, Tahtacı G, Balcık O. Role of platelets in inflammation. Dicle Tip Derg. 2012;39(3):455-457.
  • Wei Y, Wang T, Li G, et al. Investigation of systemic immune-inflammation index, neutrophil/high-density lipoprotein ratio, lymphocyte/high-density lipoprotein ratio, and monocyte/high-density lipoprotein ratio as indicators of inflammation in patients with schizophrenia and bipolar disorder. Front Psychiatry. 2022;13:941728.
  • Vogelzangs N, Beekman AT, de Jonge P, Penninx BW. Anxiety disorders and inflammation in a large adult cohort. Transl Psychiatry. 2013;3(4):e249.
  • Hou R, Garner M, Holmes C, et al. Peripheral inflammatory cytokines and immune balance in generalised anxiety disorder: case-controlled study. Brain Behav Immun. 2017;62:212-218.
  • Heidt T, Sager HB, Courties G, et al. Chronic variable stress activates hematopoietic stem cells. Nat Med. 2014;20(7):754-758.
  • Bhikram T, Sandor P. Neutrophil-lymphocyte ratios as inflammatory biomarkers in psychiatric patients. Brain Behav Immun. 2022;105:237-246.
  • Lin BD, Hottenga JJ, Abdellaoui A, et al. Causes of variation in the neutrophil-lymphocyte and platelet-lymphocyte ratios: a twin-family study. Biomark Med. 2016;10(10):1061-1072.
  • Brinn A, Stone J. Neutrophil-lymphocyte ratio across psychiatric diagnoses: a cross-sectional study using electronic health records. BMJ Open. 2020;10(7):e036859.
  • Kok Kendirlioglu B, Arat Celik HE, Buyuksandalyaci Tunc AE, et al. Lymphocyte-related ratios, systemic immune-inflammatory and systemic inflammatory response index in alcohol use disorder. J Immunoassay Immunochem. 2024;45(1):38-49.
  • Unal Demir F, Ozsoy F, Akpınar Aslan E. Inflammation in chronic psychiatric patients: neutrophil/lymphocyte ratios, platelet/lymphocyte ratios, and mean platelet volume. KSU Med J. 2023;18(2):53-59.
  • Uzun N, Akıncı MA. Hemogram parameters in childhood anxiety disorders: could anxiety disorders be related with inflammation? Med Hypotheses. 2021;146:110440.
  • Amitai M, Kaffman S, Kroizer E, et al. Neutrophilto-lymphocyte and platelet-to-lymphocyte ratios as biomarkers for suicidal behavior in children and adolescents with depression or anxiety treated with selective serotonin reuptake inhibitors. Brain Behav Immun. 2022;104:31-38.
  • Gurok MG, Yılmaz S, Temizkan A, Ustundag B, Atmaca M. Levels of basophils and eosinophils are elevated while lymphocytes are reduced in patients with panic disorder compared to controls: a preliminary study. Psychiatr Clin Psychopharmacol. 2019;29(3):315-319.
  • Özyurt G, Binici NC. The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in adolescent obsessive-compulsive disorder: does comorbid anxiety disorder affect inflammatory response? Psychiatry Res. 2019;272:311-315.
  • Öztürk S, Erdoğan M, Turan Y. Systemic immune-inflammation index and high-sensitivity cardiac troponin T in acute coronary syndromes. Acta Med Alanya. 2021;5(3):218-225.
  • Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic ımmune-ınflammation ındex (SII) can be an early indicator for predicting the severity of acute pancreatitis: a retrospective study. Int J Gen Med. 2021;14:9483-9489.
  • Zhou YX, Li WC, Xia SH, et al. Predictive value of the systemic immune inflammation index for adverse outcomes in patients with acute ischemic stroke. Front Neurol. 2022;13:836595.
  • Aziz MH, Sideras K, Aziz NA, et al. The systemic-immune-inflammation Index independently predicts survival and recurrence in resectable pancreatic cancer and its prognostic value depends on bilirubin levels: a retrospective multicenter cohort study. Ann Surg. 2019;270(1):139-146.
  • Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84(Part A):229-236.
  • Liu X, Bai X, Ren R, et al. Association between depression or anxiety symptoms and immune-inflammatory characteristics in in-patients with tuberculosis: a cross-sectional study. Front Psychiatry. 2022;13:985823.
  • Dionisie V, Filip GA, Manea MC, et al. Neutrophil-to-lymphocyte ratio, a novel inflammatory marker, as a predictor of bipolar type in depressed patients: a quest for biological markers. J Clin Med. 2021;10(9):1924.
  • Inaltekin A, Yağci İ. Evaluation of simple markers of inflammation and systemic immune inflammation index in schizophrenia, bipolar disorder patients and healthy controls. Turk Psikiyatri Derg. 2023;34(1):11-15.
  • Mazza M, de Lorenzo R, Conte C, et al. Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors. Brain Behav Immun. 2020;89:594-600.
  • Huang K, Tang Y, Chen Z, et al. Comparison of hematological parameters between first-episode schizophrenia and anti-NMDAR encephalitis. Front Cell Dev Biol. 2022;10:895178.
  • Kadier K, Dilixiati D, Ainiwaer A, et al. Analysis of the relationship between sleep-related disorder and systemic immune-inflammation index in the US population. BMC Psychiatry. 2023;23(1):773.
  • Qi Q, Zhuang L, Shen Y, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer. 2016;122(14):2158-2167.
  • Wei L, Xie H, Yan P. Prognostic value of the systemic inflammation response index in human malignancy: a meta-analysis. Medicine. 2020;99(50):e23486.
  • Debnath M, Berk M, Maes M. Translational evidence for the inflammatory response system (IRS)/ compensatory immune response system (CIRS) and neuroprogression theory of major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2021;111:110343.
  • Murata S, Baig N, Decker K, Halaris A. Systemic inflammatory response index (SIRI) at baseline predicts clinical response for a subset of treatment-resistant bipolar depressed patients. J Pers Med. 2023;13(9):1408.
  • Li X, Huan J, Lin L, Hu Y. Association of systemic inflammatory biomarkers with depression risk: results from National Health and Nutrition Examination Survey 2005-2018 analyses. Front Psychiatry. 2023;14:1097196.
There are 51 citations in total.

Details

Primary Language English
Subjects Psychiatry
Journal Section Research Articles
Authors

Derya Canlı 0000-0002-0210-3922

Publication Date March 8, 2024
Submission Date January 29, 2024
Acceptance Date February 18, 2024
Published in Issue Year 2024 Volume: 6 Issue: 2

Cite

AMA Canlı D. Evaluation of systemic immune-inflammation index, systemic inflammatory response index and hematologic inflammatory parameters in generalized anxiety disorder: a controlled study. Anatolian Curr Med J / ACMJ / acmj. March 2024;6(2):161-167. doi:10.38053/acmj.1427475
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