Aim of the study:
To evaluate High sensitive C-reactive Protein (Hs CRP) and neutrophil lymphocyte ratio (NLR) in patients with Depression and to compare HsCRP and NLR in Major Depressive disorder (MDD) and Recurrent depressive disorder (RDD)

Subject or material and methods:
This was a hospital-based case control study conducted in year 2019 for 3 months duration. Ninety eight patients with Depressive disorder and 50 healthy controls were included. HAM-D, HsCRP and NLR was assessed for all subjects.

Results:
HsCRP and NLR was more in patients with Depression than in controls and this was statistically significant. HsCRP and NLR was more in RDD compared to MDD. Both HsCRP, NLR were positively correlated with age, duration of illness, number of depressive episodes and HAMD scores. The odds of suicidal ideas in depressive patients was more with increase in HsCRP and NLR.

Discussion:
To the best of our knowledge, this is the first study to compare inflammatory parameters in MDD and RDD. In our study, CRP and NLR were more in RDD compared to MDD. This could be explained by immune dysregulation and chronic inflammation in RDD. Resistance to antidepressant therapy, and relapse of depression causes an activation of inflammatory response. In the present study, we observed an association between suicidal ideas and CRP, NLR.

Conclusions:
Inflammation plays a significant role in depression as indicated by elevated HsCRP and NLR. These parameters help to assess suicidal risk. A futuristic study can be taken up to assess the effect of antidepressants on their levels.