28th National Clinical Education Symposium Presentation Abstracts

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OP-67 Sociotelism and psychiatric symptoms in medical faculty students - Page 159
fatma KARTALKırıkkale University Faculty of Medicine, Department of Psychiatry, Kırıkkale, Türkiye, Berk Arı ?ca, hatice polat

OP-68 Evaluation of Thyroid Disease in Inpatient Psychiatric Patients: A Retrospective Review - Page 160
Alp Süleyman Genç, nuray atasoy

OP-69 The Role of Psychological Pain Tolerance, Anger Rumination, and Autistic Traits in Determining Suicidal Behavior in Medical Students - Page 162
Fatma Kartal, Koray Yarız, Gulsen Teksin, Metehan Baykal, Department of Psychiatry, Kırıkkale, Türkiye, Hayriye Mihrimah Öztürk, Department of Psychiatry, Kırıkkale, Türkiye

OP-70 Suicide in Advanced-stage Cancer Patients from the Perspective of the The İnterpersonal Theory of Suicide - Page 164
Fatma Karta, Muhammed Mesut Avcı, Merve Karataş, Selim Yalçın, Hayriye Mihrimah Öztürk

OP-71 Investigation of the Relationships Between Chronotype, Loneliness, Low Self-Esteem, and Internet Gaming Disorder: A Cross-Sectional Study - Page 166
Erdi Arıkan, Ahmet Üzer, Ekrem Furkan Uçak, Betül Kurtses Gürsoy, Hayrunnisa Hanne Dağlı Arıkan

OP-72 Evaluation of inflammatory markers in patients with chronic psychotic disorder and first-episode psychosis compared to a healthy control group - Page 168
Zülal BulanKarabük Training and Research Hospital, Department of Mental Health and Diseases, Karabük, Nefise Demir

21 APRIL 2026, TUESDAY
08:45- 10:00 "OP-66 Effects of Electroconvulsive Therapy on Hemogram-Derived Inflammatory Indices in Bipolar Mania: A Case–Control Study"

OP-66 Effects of Electroconvulsive Therapy on Hemogram-Derived Inflammatory Indices in Bipolar Mania: A Case–Control Study

İrem Demiral1, Sinay Önen1, Emine Merve Akdağ1

1. University of Health Sciences, Bursa Yuksek İhtisas Training and Research Hospital, Department of Psychiatry, Bursa, Türkiye

DOI: 10.5080/61upk.ozt481 Page 157

BACKGROUND AND AIM:Bipolar mania has been linked to peripheral immune activation and low-grade inflammation, while the mechanisms of ECT remain unclear. Hemogram derived indices(e.g., NLR,PLR,MLR) and composite measures such as SII,SIRI,PIV are practical, low-cost surrogates of systemic inflammation(1). We compared these indices between manic bipolar patients and healthy controls and assessed pre–post ECT changes.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):The study included 34 patients with bipolar disorder who received ECT during the manic phase and 42 healthy controls. Pre- and post-ECT blood samples were collected to assess Hemogram-Derived Inflammatory Indices including neutrophil lymphocyte ratio(NLR), platelet-lymphocyte ratio(PLR), monocyte-lymphocyte ratio(MLR), neutrophil-platelet ratio(NPR), systemic immune-inflammation index(SII), systemic inflammation response index (SIRI) and pan-immune-inflammation value(PIV). Clinical outcomes were measured using the Young Mania Rating Scale(YMRS) and Clinical Global Impression(CGI) scale (Ethics Committee Approval No:2011-KAEK-25 2019/04-19).
RESULTS:Before ECT, the bipolar mania group differed significantly from healthy controls in terms of NLR(p = 0.015), NPR(p = 0.018), MLR(p=0,001), SII(p=0.024), SIRI (p<0,001), and PIV(p=0,001). Following ECT, no significant changes were detected in NLR (p=0.122), PLR(p=0.149), NPR(p=0.185), MLR(p=0.713), SII(p=0.139), SIRI(p=0.675) or PIV(p=0,884) within the bipolar mania group.
CONCLUSIONS:Despite marked clinical improvement after ECT, hemogram-derived indices showed no significant pre–post change. Consistent with our null pre–post changes in hemogram-derived indices, prior bipolar ECT case–control data likewise found no significant change in NLR or PLR and reported that NLR remained higher than in healthy controls after ECT (1-3). The stronger statistical separation between the mania and healthy control groups observed for monocyte-inclusive indices (MLR, SIRI, and PIV) may indicate a predominantly monocyte-driven inflammatory signal in bipolar mania and suggest that these composite measures are more sensitive to case–control differences than classical ratios such as NLR or PLR. Future studies should standardize timing, use multiple time points, and add CRP- and monocyte- based measures. Keywords: Bipolar disorder, electroconvulsive therapy, inflammation, inflammatory indices