摘要:

ObjectivesThe goals of this study were to investigate whether depression is associated with cellular immunity in ambulatory patients and to identify neuroendocrine and behavioral pathways that might account for this relationship.MethodsWe studied 32 women who metDiagnostic and Statistical Manual of Mental Disorder, fourth edition, criteria for major depressive disorder and 32 healthy female control subjects. The groups were matched for age and ethnicity. None were taking medication, and all were free of disease involving the immune system.ResultsDepressed subjects had reduced proliferative responses to the mitogens concanavalin A and phytohemagglutinin compared with control subjects. Natural killer cell activity was reduced among older depressed subjects but enhanced among younger depressed subjects. Although depression was associated with elevated circulating levels of norepinephrine and estradiol, these hormones could not account for the immunologic differences between depressed and control subjects. Depression was also associated with greater tobacco and caffeine consumption, less physical activity, and poorer sleep quality. Mediational analyses were consistent with physical activity acting as a pathway through which depression was associated with reduced lymphocyte proliferation.ConclusionsAmbulatory patients with mild to moderately severe depression exhibit reduced mitogen-stimulated lymphocyte proliferative responses and altered natural killer cell cytotoxicity. The relationship between depression and proliferative responses may be mediated by physical activity.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveThe objective of this study was to assess the relationships among chest pain, psychiatric disorder, and early experience of ill health.MethodsThe Medical Research Council National Survey of Health and Development is a population-based birth cohort study established in 1946 (N= 5362). During childhood, several informants (parents, teachers, and school physicians) were interviewed or completed questionnaires. Data were available on the subjects’ health, the health of their parents, and subjects’ personalities. At the age of 36 years, subjects were asked about chest pain using the Rose Angina Questionnaire and completed the Present State Examination, a semistructured psychiatric interview. Subjects were followed for another 7 years (to age 43 years) to determine the outcome of those with chest pain.ResultsChest pain was reported in 17.2% (95% CI = 15.9–18.5%) of respondents at 36 years. The prevalence of exertional chest pain was 1.0% (95% CI = 0.7–1.3%). There was little evidence of coronary heart disease in those with exertional pain at age 36 years when followed for 7 years. However, there was a powerful cross-sectional relationship between psychiatric disorder and chest pain (OR for psychiatric disorder and all chest pain = 3.55, 95% CI = 2.34–5.37; OR for psychiatric disorder and exertional chest pain = 29.08, 95% CI = 6.65–127.15). Childhood risk factors, including poor health reported in parents at age 15 years and fatigue during childhood, were also associated with chest pain.ConclusionsChest pain (especially exertional chest pain) is strongly associated with psychiatric disorders in young adults. Childhood experiences, including illness in parents, are associated with subsequent chest pain.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveAttitudes have a potential role to play in the experience of menopause. The objective of this study was to examine the degree to which attitudes toward menopause and aging vary across ethnic groups and menopausal status (ie, premenopausal through postmenopausal).MethodsMore than 16,000 women were interviewed by telephone as part of the Study of Women’s Health Across the Nation. They represented five ethnic/racial groups (African American, white, Chinese American, Japanese American, and Hispanic) from seven geographical sites (Boston, MA; Pittsburgh, PA; Chicago, IL; Michigan; New Jersey; and northern and southern California).ResultsAfrican American women were significantly more positive in attitude. The least positive groups were the less acculturated Chinese American and Japanese American women. Menopausal status was not a consistent predictor of attitude across ethnic groups.ConclusionsIn general, women’s attitudes toward menopause range from neutral to positive. Ethnic groups within the United States vary slightly, but reliably, in their attitudes toward menopause and aging. Factors other than those directly associated with menopausal status seem to play a role in attitude.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveSystemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by flare-ups, the causes of which are not known. In accordance with new concepts in stress research, this study investigated whether daily psychosocial stressors interfere with immunological processes in SLE. Because such processes are unique to each individual, single-case design using time-series analysis (Box and Jenkins) was applied.MethodsA 40-year-old woman with SLE (last flare-up September 1995) was interviewed initially to determine major life events and difficulties (using the Life Events and Difficulties Schedule) in the previous 2 years. She was then observed for 63 days. Urine neopterin, an immunological parameter demonstrated to parallel disease activity in SLE patients, was measured in daily overnight urine. Daily incidents were identified weekly by the Incidents and Hassles Inventory and independently rated. Intervening factors, including infections, medication, and lifestyle, were controlled.ResultsRetrospectively, data obtained from the Life Events and Difficulties Schedule indicated that major life events and difficulties had preceded the patient’s last flare-up in 1995. Although there were no clinical signs of SLE during this prospective study of 63 days, cross-correlational analyses revealed that “moderately” stressful incidents associated with higher levels of emotional irritation (lag 0: +0.271,p< .05) predicted an increase in urine neopterin the following day (lag 1: +0.441,p< .05). Moreover, a 7-day cyclicity in neopterin levels that corresponded to the weekly examinations and interviews was found.ConclusionsThis study showed a causal relationship between psychosocial stressors and urine neopterin concentrations that may be related to SLE disease activity. Furthermore, the workability of an integrative approach using single-case design and time-series analysis in psychoneuroimmunology was demonstrated for the first time.

ISSN:0033-3174    

出版商:OVID    

年代:1999

数据来源: OVID