Inflammation markers in patients with psychotic disorder who have committed offenses and their relationship with criminal behavior

Abstract

The role of inflammation in the etiology of psychotic disorders (PD) is well-established. This study aimed to identify inflammation parameters in patients diagnosed with PD, assess their potential as biomarkers, and examine their relationship with criminal behavior. This retrospective study comprised three groups: 530 patients diagnosed with PD who had committed crimes (offenders with PD), 530 patients with PD who had not committed crimes (non-offenders with PD), and 530 healthy controls, totaling 1,590 participants. Routine hematological tests were used to measure neutrophil, lymphocyte, monocyte, and platelet counts, high-density lipoprotein (HDL), systemic inflammatory response index (SIRI), systemic immune-inflammatory index (SII), and neutrophil/HDL (NHR), lymphocyte/HDL, platelet/HDL (PHR), and monocyte/HDL (MHR) ratios. Offenders with PD exhibited significantly higher levels of SII, SIRI, PHR, NHR, LHR, neutrophils, and monocytes compared to non-offenders with PD and healthy controls (p < 0.001). The criminal group had lower HDL and lymphocyte levels than the remaining two groups (p < 0.001). Among those treated in forensic psychiatry units, patients with two or more treatments showed significantly higher SIRI values compared to those with only one treatment (p = 0.045). Non-offenders with PD had higher platelet values than the remaining two groups (p < 0.001). This study underscores the role of systemic inflammation in the pathophysiology of psychotic disorders through a comparison of patients who have and have not committed crimes, highlighting the relationship between inflammation and lipid metabolism. Further research is required to clarify these findings.