Previously submitted to: JMIR Mental Health (no longer under consideration since Feb 18, 2025)
Date Submitted: Feb 18, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Enhancing Quality of Life in Diabetic Nephropathy Patients: The Impact of a Multifaceted Psychological Intervention
ABSTRACT
Background:
Patients with diabetic nephropathy (DN) frequently encounter negative emotions and diminished quality of life, largely influenced by the neuroendocrine-immune axis. This study seeks to explore how a multifaceted psychological intervention can ameliorate these effects and unravel the molecular pathways involved.
Objective:
To investigate the impact of a multimodal psychological intervention on negative emotions and quality of life in DN patients, and to unravel the key regulatory gene networks through bioinformatic analysis.
Methods:
Sixty DN patients were randomly assigned to either an intervention group receiving an 8-week program of cognitive behavioral therapy, mindfulness meditation, and relaxation training, or a control group receiving standard care. Assessments of emotional parameters were conducted using standardized scales, while serum markers were measured through ELISA. Bioinformatic analyses including GO/KEGG enrichment and PPI network analysis were performed to elucidate the molecular mechanisms.
Results:
The intervention group demonstrated remarkable improvements in negative emotions and quality of life, evidenced by lowered HADS scores and increased SF-36 scores. Significant reductions in cortisol, CRH, ACTH, IL-6, IL-1β, and TNF-α were observed in the intervention group. Bioinformatic analysis unveiled upregulated genes linked to immune regulation and inflammation, with IL-6 identified as a central player in the inflammatory network.
Conclusions:
The multimodal psychological intervention effectively enhanced negative emotions and quality of life in DN patients by modulating IL-6 and associated pathways within the neuroendocrine-immune axis. IL-6 emerged as a critical regulatory factor, offering insights for potential clinical interventions.
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