Comparative analysis of inflammatory biomarkers in methamphetamine-associated psychosis and schizophrenia

Methamphetamine-associated psychosis (MAP) can present a spectrum of clinical manifestations, ranging from transient psychotic symptoms to a full-blown primary psychotic disorder. Differentiating between acute exacerbations of MAP and primary psychotic disorders remains challenging due to the overlapping clinical symptoms. In this study, we aimed to investigate whether CBC-derived inflammatory markers, C-reactive protein/albumin ratio (CAR), and neutrophil/albumin ratio (NAR) levels can be used as inflammatory markers in the differential diagnosis of MAP and schizophrenia.

The study sample included 206 patients hospitalized with acute exacerbation of psychosis (103 diagnosed with MAP, 103 diagnosed with schizophrenia) and 103 matched healthy controls. Logistic regression models were developed to determine the predictive value of group membership: Model 1 compared schizophrenia and MAP; Model 2 compared MAP and the control group; Model 3 compared the schizophrenia and the control group.

NLR, MLR, PLR, and NAR levels were significantly higher in patients with schizophrenia and MAP when compared with healthy controls. The NLR level was found to be a significant predictor of group membership in regression analysis for schizophrenia (Model 1, Model 3; p < 0.001). As a result of the regression model created with the MAP patients and control group, NAR was found to be a predictive variable for the MAP patients (Model 2, p = 0.011).

The results showed that NLR may be a potential biomarker for distinguishing patients with schizophrenia from patients with MAP and healthy controls. NAR level may be a potential biomarker for distinguishing MAP patients from healthy controls.