Biological modulators of treatment outcome during psychiatric care: The interplay between inflammation and oxytocin

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Higher pre-treatment neutrophil-to-lymphocyte ratio predicts reduced improvement in trait anxiety during inpatient psychiatric care.
Oxytocin administration improved depressive outcomes only among patients with low baseline NLR, not among those with high baseline NLR.
Inflammation may shape treatment outcomes and further studies should test other anti-inflammatory agents to buffer high NLR effects.

Psychoneuroendocrinology. 2026 May 14;189:107894. doi: 10.1016/j.psyneuen.2026.107894. Online ahead of print.

ABSTRACT

BACKGROUND: Although scientific advancements highlight the involvement of inflammatory processes in psychiatric disorders, few studies have explored how these processes relate to treatment outcomes. This study aimed to examine whether inflammation is associated with reduced treatment outcomes in inpatient psychiatric care, and whether oxytocin (OT) – a neuropeptide known for its anti-inflammatory properties – may buffer these effects.

METHODS: Patients (N = 72, 76% females) who received intranasal OT or placebo twice daily for four weeks adjacent to standard inpatient care were examined for their pre-treatment inflammation, using the neutrophil-to-lymphocyte ratio (NLR). Baseline Depressive symptoms, anxiety, suicidal ideation, and distress were assessed using self-report measures at pre and post-treatment. Multilevel models were utilized to test the predictive effects of baseline NLR on treatment outcomes and its interaction with OT administration.

RESULTS: Higher pre-treatment NLR was associated with reduced improvement in trait anxiety (p = .02). A significant NLR × OT interaction emerged for depression (p = .005), indicating that OT administration did not significantly improve depression outcomes for patients with high baseline NLR (p = .35), but was associated with greater improvement among patients with low baseline NLR compared to placebo (p = .001).

CONCLUSIONS: Inflammation is a potential biological factor shaping treatment outcome, however, OT administration benefits mostly those with low inflammation. Additional studies are needed to assess whether other anti-inflammatory agents may buffer its effects.

PMID:42156189 | DOI:10.1016/j.psyneuen.2026.107894

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