Positive Health Online

Abstract

KIECOLT-GLASER and colleagues, Department of Psychiatry, Ohio State University, Columbus, Ohio 43210, USA, kiecolt-glaser.1@osu.edu, reviewed (155 references) early and recent research relevant to the field of psychoneuroimmunology (PNI).

Background

Brain-immune modulation is now a well-established phenomenon, with an explosion of research and literature on the subject appearing over the last decade. The history of the field goes back much farther, however, largely under the auspices of studies in psychosomatic medicine. This article reviews that history and speculates on where PNI may take us in the future.

Methodology

Human PNI studies published since 1939, particularly in the journal Psychosomatic Medicine, are reviewed here. Studies were grouped according to key themes, such as: stressor duration and characteristics (e.g. laboratory stressors, short-term stressors, chronic stress); influences of psychopathology, personality or interpersonal relationships; and immune responses to behavioural interventions. The authors also examined population trends, changes and developments in immunological assessment methods, health outcomes and likely future directions in the field of PNI.

Results

The body of evidence is now sufficient to conclude that psychosocial stressors or interventions can cause alterations in immune function that can result in actual changes in health. The strongest evidence of this is in the areas of infectious diseases and wound healing. In addition, it is now apparent that the onset and course of a range of common diseases are significantly influenced by proinflammatory cytokines; such conditions range from cardiovascular disease to loss of function and frailty such as those commonly associated with ageing. Numerous studies have demonstrated that negative emotions (e.g. anger, depression, despair) and stressful experiences can directly stimulate production of proinflammatory cytokines; chronic or recurrent infections are also indirect stimulators of these agents. Thus, the wide range of health risks associated with negative emotions may be mediated, in large part, by distress-related disturbances of normal immune function.

Conclusion

The facts of PNI have far-reaching implications for basic biological sciences, academic and clinical medicine and the effectiveness of healthcare.

References

Kiecolt-Glaser JK et al. Psychoneuroimmunology and psychosomatic medicine: back to the future. Psychosomatic Medicine 64 (1): 15-28. Jan-Feb 2002.

Comment

Kiecolt-Glaser are amongst the giants in the field of psychoneuroimmunology. This review summarizes the vast research which substantiates how the mind has a powerful influence upon health, as also discussed in the featured cover stories. The importance of psychosocial and emotional factors to disease and general health must now finally be given the emphasis they merit, starting with the medical school curriculum and finishing up in medical consultations placing the overall wellbeing of the patient as the supreme consideration.