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Immune-impulsivity link: association between peripheral inflammatory ratios and borderline personality disorder

Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To determine associations between impulsivity and peripheral inflammatory ratios in patients with borderline personality disorder (BPD). METHODS: Consecutive patients aged ≥18 years with a diagnosis of BPD who presented to the Institute of Mental Health and Neurosciences Kashmir, India, between November 2024 and June 2025 were invited to participate. Recent self-harm was recorded. A blood sample (3 mL) was collected from each patient; levels of white blood cells, neutrophils, lymphocytes, monocytes, platelets, and erythrocyte sedimentation rate were recorded. The neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio were calculated. BPD symptomatology was assessed using the self-report Borderline Personality Questionnaire (BPQ). Impulsivity was assessed using the self-report Urgency, Premeditation, Perseverance, Sensation Seeking-Impulsive Behaviour Scale, short version (UPPS-S). RESULTS: In total, 26 women and seven men (mean age, 21.2 years) were included in the analysis. Of these, 17 reported recent self-harm and the remaining 16 did not; the two groups did not differ significantly in terms of peripheral inflammatory ratios. In Pearson correlation analysis, MLR showed a trend towards correlation with the UPPS-S (r = 0.338, p = 0.055) and BPQ (r = 0.324, p = 0.066). In multivariate regression analysis, MLR remained associated with the UPPS-S (β = 0.460, p = 0.017) and BPQ (β = 0.358, p = 0.056). CONCLUSION: Although patients with BPD with or without recent self-harm did not differ significantly in terms of peripheral inflammatory ratios, the specific association between higher MLR and greater impulsivity suggests that immune abnormalities are linked to impulsivity in BPD.
DOI: 10.12809/eaap25128
Language: English
Field: Psychology
Open Access status: diamond
OpenAlex ID: W7147448114
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