Publication Name	World Journal of Psychiatry
Manuscript ID	119439
Country	China

Category	Psychiatry
Manuscript Type	Observational Study
Article Title	Divergent lymphocyte associations with depression severity and case status in first-episode, drug-naive adolescents: A multicenter study
Manuscript Source	Unsolicited Manuscript
All Author List	Xi-Wang Fan, Jia-Zhe Hou, Yi-Zhe Wang, Ming-Lin Gao, Ying Shen, Dai Jian, Qin Zhou, Jing Yang, Hui Zhao and Li-Juan Zhang
Funding Agency and Grant Number	Funding Agency Grant Number National Natural Science Foundation of China 81872720 the Shanghai Municipal Health Commission 2023ZZ02027 the National Clinical Key Specialty Construction Project of China Z155080000004
Corresponding Author	Li-Juan Zhang, PhD, Health Management Center, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, No. 50 Chifeng Road, Yangpu District, Shanghai 201613, China. zhangxiaoyi@tongji.edu.cn
Key Words	Adolescent depression; Lymphocyte count; Lymphocyte-to-monocyte ratio; Peripheral immunity; Severity; Multicenter study
Core Tip	This two-stage multicenter study reveals a divergent immunopurified in first-episode, drug-naive adolescents with major depressive disorder. While patients exhibited significantly lower lymphocyte counts and lymphocyte-to-monocyte ratios than healthy controls, higher levels of these markers paradoxically correlated with greater disease severity, particularly in females. A composite model integrating these indices demonstrated robust diagnostic discrimination (area under the curve = 0.82). These findings support a stage-dependent immunopsychiatric paradigm, suggesting that routine peripheral immune metrics offer a practical, objective tool for identifying major depressive disorder and stratifying severity in youth.
Citation	Fan XW, Hou JZ, Wang YZ, Gao ML, Shen Y, Jian D, Zhou Q, Yang J, Zhao H, Zhang LJ. Divergent lymphocyte associations with depression severity and case status in first-episode, drug-naive adolescents: A multicenter study. World J Psychiatry 2026; In press

Received	2026-01-29 03:41
Peer-Review Started	2026-01-29 03:42
First Decision by Editorial Office Director	2026-02-09 09:18
Return for Revision	2026-02-09 09:18
Revised	2026-02-22 07:39
Publication Fee Transferred	2026-02-27 09:11
Second Decision by Editor	2026-03-24 02:51
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-03-24 07:16
Articles in Press	2026-03-24 07:16
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ISSN	2220-3206 (online)
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