IL-6 may mediate psychosomatic syndromes in HF patients

Levels of the proinflammatory cytokine interleukin (IL)-6 seem to be associated with psychosomatic symptoms in patients with heart failure (HF), reports a recent study.

Researchers enrolled 41 consecutive HF outpatients (mean age 70.9 years, 83 percent men), in whom psychosomatic psychopathology was evaluated using the Diagnostic Criteria for Psychosomatic Research (DCPR) and the Patient Health Questionnaire-15 (PHQ-15). Blood samples were collected and subjected through enzyme-linked immunosorbent assays for the measurement of IL-6 and tumour necrosis factor (TNF)-alpha.

More than half (56.1 percent; n=23) of participants had at least DCPR syndrome, including persistent somatization, demoralization, and irritable mood; six patients (14.6 percent) had multiple psychosomatic diagnoses.

Compared with those who had no DCPR diagnoses, PHQ-15 somatization scores, depression, and psychological distress were all significantly elevated in patients who had at least one psychosomatic syndrome. No such difference was reported for basic demographic and lifestyle factors, as well as cardiac parameters.

Adjusted regression analysis found that IL-6 levels were significantly and positively associated with DCPR syndromes (β, 0.44, 95 percent confidence interval [CI], 0.01–0.88; p=0.04) and PHQ-15 (β, 0.60, 95 percent CI, 0.21–0.92; p=0.003), but not with depression, stress, well-being, or psychological distress. In comparison, TNF-alpha was not associated with psychosomatic manifestations.

“Results suggest a possible psychoneuroimmune link between psychosomatic psychopathology and HF. This information may provide clinicians with more accurate data that can be used to successfully manage such patients,” the researchers said.

“Further studies are recommended to replicate these findings and to study the relationship between psychosomatic dimensions and inflammation in HF,” they added.