OBJECTIVE: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and red cell distribution width (RDW) were determined to be good indicators of inflammatory status. The aim of this study was to investigate NLR, PLR, MPV, and RDW, which can provide insight into diagnosis and/or prognosis in adolescents with major depressive disorder (MDD) compared to controls. METHOD: A total of 103 patients diagnosed with MDD, who received no antidepressant therapy within the past 1 month, were included in the study. The control group consisted of 41 healthy subjects with no organic and psychiatric disorders. RESULTS: NLR and MPV values were significantly high in adolescents with MDD compared with healthy controls (2.00 ± 0.80 vs. 1.63 ± 0.64, P = .011; 10.25 ± 0.91 vs. 9.62 ± 1.23, P = .005). There was no difference between the groups on PLR and RDW. There was a positive correlation between NLR and Children's Depression Scale (CDI) scores in the total study group (r = 0.229, P = .006). There was also a positive correlation between MPV and CDI scores in the total study group (r = 0.185, P = .028). CONCLUSION: The findings of the study reveal that NLR and MPV tend to be higher in adolescents with MDD, and higher NLR values are associated with higher CDI scores in adolescents. The findings of this study are consistent with the relevant literature of inflammatory status in MDD. Our study gave us an idea of the need for larger sample study on the routine use of blood parameters in adolescent depression.

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Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder with recurrent obsessions and/or compulsions that cause distress, time-consuming and/or significant disruption (1). The prevalence of OCD is %1-3 (2). OCD is divided into 2 groups according to the age of onset; early onset (12-14 years) and late onset (20-22 years) (3,4). Childhood-onset OCD is suggested to be distinguished with late-onset OCD by different etiopathogenic mechanisms (4,5). The pathophysiology of OCD is still unknown, recent studies have focused primarily on neurotransmitters, such as serotonin, dopamine, and glutamate (6,7). The previous studies have focused on environmental factors such as psychosocial stressors, trauma, and other infectious and their effects on inflammatory process. The inflammatory processes alter gene expression in a way that influences the serotoninergic and dopaminergic systems, catecholamine modulation, and glutamate pathways (8,9). Although the etiopathology is still unclear, these changes in the paths that process corticostriatal information are thought to be because of epigenetic mechanisms and have a causative role in OCD symptoms (10). Studies regarding the pathophysiology of OCD have emphasized the importance of immunological mechanisms (10-12). The relation between Group A β-hemolytic streptococcus infections and OCD onset or exacerbation in some children also show that immunological factors play a role in the etiology of OCD (13). Besides to streptococcus infection, other infectious diseases such as Borrelia burgdorferi, mycoplasma, Toxoplasma gondii, or Borna disease virus have been related with OCD (11,14).

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Children diagnosed with autistic spectrum disorders (ASD) may have serious behavioral problems such as aggression, self-injury, and violence. However, the literature on ASD either overrules any correlation between aggression and ASD or maintains the fact that the efforts to link them have so far been inconclusive. Although severe forms of violence are extremely rare in children with autism, there are a few cases reported in the literature with significant harm to siblings. We hereby report an 8-year-old boy with ASD who caused the death of his sibling by throwing her out of the window. Shared similarities of all defenestration cases indicate a pattern of high-risk behavior threatening the survival of minors. We recommend precautions against this high-risk behavior in children with ASD.