{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T08:40:06Z","timestamp":1752136806388,"version":"3.41.2"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic obstructive pulmonary disease (COPD) is increasingly prevalent in respiratory medicine, with rising incidence and mortality rates annually. Beyond respiratory implications, it leads to cardiovascular events, osteoporosis, muscle loss, and psychosomatic syndrome, often overlooked yet pivotal in COPD prognosis. Despite this, the relationship between COPD and psychosomatic syndrome remains unclear. This study aimed to explore the correlation between acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients and psychosomatic syndrome, alongside peripheral blood inflammatory factors and symptom burden (e.g., modified Medical Research Council [mMRC] and COPD assessment test [CAT]). Identifying high-risk AECOPD patients with psychosomatic syndrome through these markers could enable early intervention and improve prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This observational study recruited 202 AECOPD patients admitted to the Respiratory and Critical Care Medicine Department of Shanghai Jiading Central Hospital from March 1st, 2022 and May 1st, 2024. After obtaining consent, we collected demographic data, blood routine results, albumin, prealbumin, lung function metrics, mMRC, CAT scores, and other parameters. We evaluated psychiatric comorbidities using the revised version of the Diagnostic Criteria for Psychosomatic Research (DCPR-R). Binary logistic regression and ROC curve analyses were employed to assess the correlation between inflammatory factors, symptom burden, and psychosomatic syndrome, as well as their diagnostic and predictive value for psychosomatic syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 202 AECOPD patients, 144 were in the DCPR (+) group and 58 in the DCPR (-) group. The DCPR (+) group had higher white blood cell counts, neutrophil counts, monocyte counts, interleukin (IL)-6 levels, mMRC scores, and CAT scores than those of the DCPR (-) group, (P &amp;lt; 0.05), Albumin and prealbumin levels were significantly lower in the DCPR (+) group than those in the DCPR (-) group (P &amp;lt; 0.05). There were no significant differences between the two groups in terms of age, sex, marital status, years of education, body mass index, smoking history, drinking history, diabetes, hypertension, PaCO<jats:sub>2<\/jats:sub>, PaO<jats:sub>2<\/jats:sub>, neutral ratio, lymphocyte count, monocyte ratio, FEV<jats:sub>1<\/jats:sub>% pred, and FEV<jats:sub>1<\/jats:sub>\/FVC% (P &amp;gt; 0.05). Multivariate binary logistic regression analysis identified IL-6, mMRC, and CAT score as independent risk factors for psychosomatic syndrome in AECOPD patients. The odds ratios (OR) and 95% confidence intervals (CI) were: IL-6: OR=1.192 (95% CI: 1.091-1.302), P &amp;lt; 0.001; mMRC: OR=1.922 (95% CI: 1.175-3.144), P = 0.009; CAT: OR=1.149 (95% CI: 1.073-1.231), P &amp;lt; 0.001.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Peripheral blood IL-6, mMRC, and CAT were independent risk factors for psychiatric comorbidities in AECOPD patients, with good predictive value for psychosomatic integration. Subjective symptoms including cough, phlegm, sleep disturbances, lack of confidence in going out, and difficulty breathing contribute more to psychiatric comorbidities than the objective indicator of FEV<jats:sub>1<\/jats:sub>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1586399","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T08:26:41Z","timestamp":1752136001000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation between serum inflammatory factors and psychosomatic syndrome in patients with chronic obstructive pulmonary disease: an observational study"],"prefix":"10.3389","volume":"16","author":[{"given":"Wenjing","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujuan","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunlin","family":"Tu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanfang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1900164","DOI":"10.1183\/13993003.00164-2019","article-title":"Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019","volume":"53","author":"Singh","year":"2019","journal-title":"Eur Respir J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S2213-2600(21)00506-3","article-title":"Chronic obstructive pulmonary disease in never-smokers: risk factors, pathogenesis, and implications for prevention and treatment","volume":"10","author":"Yang","year":"2022","journal-title":"Lancet Respir Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30105-3","article-title":"Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"8","year":"2020","journal-title":"Lancet Respir Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2017.1353416","article-title":"The potential role of endothelial dysfunction and platelet activation in the development of thrombotic risk in COPD patients","volume":"10","author":"Malerba","year":"2017","journal-title":"Expert Rev Hematol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S254437","article-title":"The summit score stratifies mortality and morbidity in chronic obstructive pulmonary disease","volume":"15","author":"Horne","year":"2020","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S313841","article-title":"The relationship between anxiety, depression and treatment adherence in chronic obstructive pulmonary disease: A systematic review","volume":"16","author":"Volpato","year":"2021","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2016.06.006","article-title":"Prevalence of depression in COPD: A systematic review and meta-analysis of controlled studies","volume":"117","author":"Matte","year":"2016","journal-title":"Respir Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2011.03.009","article-title":"Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: a systematic review, meta-analysis and meta-regression","volume":"33","author":"Zhang","year":"2011","journal-title":"Gen Hosp Psychiatry"},{"key":"B9","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1016\/j.ejphar.2018.10.001","article-title":"Psychological co-morbidities in COPD: Targeting systemic inflammation, a benefit for both","volume":"842","author":"Pelgrim","year":"2019","journal-title":"Eur J Pharmacol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/arm91020011","article-title":"The impact of anxiety and depression in chronic obstructive pulmonary disease","volume":"91","author":"Rahi","year":"2023","journal-title":"Adv Respir Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1186\/s12890-022-01934-y","article-title":"Impact of anxiety and depression on the prognosis of copd exacerbations","volume":"22","author":"Mart\u00ednez-Gestoso","year":"2022","journal-title":"BMC Pulm Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1016\/j.arbres.2021.03.013","article-title":"COPD is more than just lung function: let\u2019s not forget depression","volume":"57","author":"Garc\u00eda Sanz","year":"2021","journal-title":"Arch Bronconeumol (Engl Ed)"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17010022","article-title":"Mind-body exercise for anxiety and depression in COPD patients: A systematic review and meta-analysis","volume":"17","author":"Li","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.1.60","article-title":"Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life","volume":"167","author":"Ng","year":"2007","journal-title":"Arch Intern Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1038\/srep06202","article-title":"Association between the IL1B, IL1RN polymorphisms and COPD risk: a meta-analysis","volume":"4","author":"Xie","year":"2014","journal-title":"Sci Rep"},{"key":"B16","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1136\/thx.2008.111278","article-title":"Associations of IL6 polymorphisms with lung function decline and COPD","volume":"64","author":"He","year":"2009","journal-title":"Thorax"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21062194","article-title":"Role of interleukin-6 in depressive disorder","volume":"21","author":"Ting","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e199","DOI":"10.1038\/tp.2012.120","article-title":"Evidence for sustained elevation of IL-6 in the CNS as a key contributor of depressive-like phenotypes","volume":"2","author":"Sukoff Rizzo","year":"2012","journal-title":"Transl Psychiatry"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2023.156404","article-title":"Inflammation and comorbidities of chronic obstructive pulmonary disease: The cytokines put on a mask","volume":"172","author":"Long","year":"2023","journal-title":"Cytokine"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3233\/THC-230665","article-title":"Relationship between serum Th1\/Th2 imbalance and depression in elderly patients with COPD and its clinical implications","volume":"31","author":"Zhang","year":"2023","journal-title":"Technol Health Care"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S53255","article-title":"Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: a systematic review","volume":"9","author":"Pooler","year":"2014","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2011.03.005","article-title":"Acute exacerbations of chronic obstructive pulmonary disease and the effect of existing psychiatric comorbidity on subsequent mortality","volume":"52","author":"Abrams","year":"2011","journal-title":"Psychosomatics"},{"key":"B23","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.jpsychores.2009.06.013","article-title":"The proposed diagnosis of somatic symptom disorders in DSM-V: two steps forward and one step backward","volume":"68","author":"Schr\u00f6der","year":"2010","journal-title":"J Psychosom Res"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1159\/000430788","article-title":"The clinical utility of the diagnostic criteria for psychosomatic research: A review of studies","volume":"84","author":"Porcelli","year":"2015","journal-title":"Psychother Psychosom"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1159\/000437148","article-title":"Influence of DCPR syndromes in the psychosocial functioning of patients with major depressive and bipolar disorders","volume":"84","author":"Altamura","year":"2015","journal-title":"Psychother Psychosom"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0265282","DOI":"10.1371\/journal.pone.0265282","article-title":"Psychosomatic syndromes are associated with IL-6 pro-inflammatory cytokine in heart failure patients","volume":"17","author":"Altamura","year":"2022","journal-title":"PloS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1159\/000448856","article-title":"Current psychosomatic practice","volume":"86","author":"Fava","year":"2017","journal-title":"Psychother Psychosom"},{"key":"B28","doi-asserted-by":"publisher","first-page":"2300239","DOI":"10.1183\/13993003.00239-2023","article-title":"Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary","volume":"61","author":"Agust\u00ed","year":"2023","journal-title":"Eur Respir J"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.2766","article-title":"Clinical utility of the Diagnostic Criteria for Psychosomatic Research for a comprehensive assessment of the elderly","volume":"29","author":"Mansueto","year":"2022","journal-title":"Clin Psychol Psychother"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2017.03.002","article-title":"Subsyndromal psychosomatic concepts and personality traits in community adults","volume":"75","author":"Liao","year":"2017","journal-title":"Compr Psychiatry"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1159\/000541404","article-title":"Study of rates and factors associated to psychosomatic syndromes assessed using the diagnostic criteria for psychosomatic research across different clinical settings","volume":"93","author":"Xu","year":"2024","journal-title":"Psychother Psychosom"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1136\/thx.54.7.581","article-title":"Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease","volume":"54","author":"Bestall","year":"1999","journal-title":"Thorax"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00102509","article-title":"Development and first validation of the COPD Assessment Test","volume":"34","author":"Jones","year":"2009","journal-title":"Eur Respir J"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.841282","article-title":"The relationship between linoleic acid intake and psychological disorders in adults","volume":"9","author":"Mohammadi","year":"2022","journal-title":"Front Nutr"},{"key":"B35","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/nri.2015.5","article-title":"The role of inflammation in depression: from evolutionary imperative to modern treatment target","volume":"16","author":"Miller","year":"2016","journal-title":"Nat Rev Immunol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2009.12.021","article-title":"Higher cortisol levels are associated with smaller left hippocampal volume in first-episode psychosis","volume":"119","author":"Mondelli","year":"2010","journal-title":"Schizophr Res"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.bbi.2016.01.017","article-title":"Chronic peripheral inflammation, hippocampal neurogenesis, and behavior","volume":"58","author":"Chesnokova","year":"2016","journal-title":"Brain Behav Immun"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2016.143","article-title":"Inflammation effects on motivation and motor activity: role of dopamine","volume":"42","author":"Felger","year":"2017","journal-title":"Neuropsychopharmacology"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.tins.2015.08.001","article-title":"Depression as a microglial disease","volume":"38","author":"Yirmiya","year":"2015","journal-title":"Trends Neurosci"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2020.06.002","article-title":"The bidirectional relationship of depression and inflammation: double trouble","volume":"107","author":"Beurel","year":"2020","journal-title":"Neuron"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2011.277","article-title":"Interleukin-1\u03b2: a new regulator of the kynurenine pathway affecting human hippocampal neurogenesis","volume":"37","author":"Zunszain","year":"2012","journal-title":"Neuropsychopharmacology"},{"key":"B42","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1007\/s10753-022-01769-z","article-title":"Hypoxia-inducible factor 1\u03b1 and its role in lung injury: adaptive or maladaptive","volume":"46","author":"Suresh","year":"2023","journal-title":"Inflammation"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200505-704OC","article-title":"Systemic and upper and lower airway inflammation at exacerbation of chronic obstructive pulmonary disease","volume":"173","author":"Hurst","year":"2006","journal-title":"Am J Respir Crit Care Med"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S322144","article-title":"Association of systemic inflammation with depressive symptoms in individuals with COPD","volume":"16","author":"Strollo","year":"2021","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"B45","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1038\/s41583-023-00729-2","article-title":"Central regulation of stress-evoked peripheral immune responses","volume":"24","author":"Chan","year":"2023","journal-title":"Nat Rev Neurosci"},{"key":"B46","doi-asserted-by":"publisher","first-page":"9","DOI":"10.14744\/ejop_78_21","article-title":"COPD and comorbidities in the republic of Moldova","volume":"24","author":"Corlateanu","year":"2022","journal-title":"Eurasian J Pulmonol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1186\/s40248-015-0023-2","article-title":"Prevalence of different comorbidities in COPD patients by gender and GOLD stage","volume":"10","author":"Negro Dal","year":"2015","journal-title":"Multidiscip Respir Med"},{"key":"B48","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.jad.2022.06.059","article-title":"Outcomes associated with comorbid anxiety and depression among patients with stable COPD: A patient registry study in China","volume":"313","author":"Wu","year":"2022","journal-title":"J Affect Disord"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S245842","article-title":"Multiple factor analysis of depression and\/or anxiety in patients with acute exacerbation chronic obstructive pulmonary disease","volume":"15","author":"Long","year":"2020","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"B50","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/s12931-017-0548-3","article-title":"Understanding the impact of symptoms on the burden of COPD","volume":"18","author":"Miravitlles","year":"2017","journal-title":"Respir Res"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5811","article-title":"Potential use of albumin and neutrophil-to-lymphocyte ratio to guide the evaluation and treatment of cancer-related depression and anxiety","volume":"31","author":"McFarland","year":"2022","journal-title":"Psychooncology"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1586399\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T08:26:42Z","timestamp":1752136002000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1586399\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,10]]},"references-count":51,"alternative-id":["10.3389\/fpsyt.2025.1586399"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1586399","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,10]]},"article-number":"1586399"}}