Cognitive behaviour therapy and inflammation: A systematic review of its relationship and the potential implications for the treatment of depression

Applications of psychoneuroimmunology models of toxic stress in prevention and intervention efforts across early development

Although evidence supporting psychoneuroimmunology (PNI) models of toxic stress have emerged over the past decade, the PNI field has struggled to integrate these important findings into real-world practical applications. There is great potential for these models to reduce the societal burden of childhood adversity by facilitating early detection and prevention with those children and adolescents at greatest risk for stress-related physical and psychological disorders. But further research is needed to validate and scale developmentally appropriate interventions with specific immune and endocrine mechanism-based targets that are developmentally sensitive. The allostatic load and additive PNI models of toxic stress exposure in youth are summarized. These models highlight the importance of integrating a standardized screening of environmental and interpersonal risk factors with stable and scalable cognitive and biological markers of risk. PNI models of toxic stress illustrate the need for intervention delivery as early as possible to prevent negative health outcomes in youth and comprehensive screening efforts would facilitate the deployment of community and family level interventions. This review discusses practical applications of toxic stress models that are currently under investigation, clarifies key obstacles, such as research gaps and scalability, and provides potential solutions, including cross-disciplinary partnerships.

The effect of cognitive behavioral therapy on the circulating proinflammatory cytokines of fibromyalgia patients: A pilot controlled clinical trial

OBJECTIVES

There is no consensus over the effect size of cognitive behavioral therapy (CBT) in the treatment of fibromyalgia (FM). This study aims to evaluate the effect of CBT on FM patients, through assessing circulating proinflammatory cytokines.

METHODS

A controlled, single-blind, parallel clinical trial was performed with 21 FM patients in each group. Sixteen FM patients in the intervention group (CBT) and 17 FM patients in the control group (waiting-list) completed the study. For the intervention group, traditional face-to-face CBT was performed for groups of 10 and 11 patients in 20 sessions. Fibromyalgia Impact Questionnaire (FIQ), widespread pain index (WPI), circulating IL-6, IL-8, and TNF-α level were evaluated before and after the intervention using enzyme-linked immunosorbent assay. Intention-to-treat analysis was performed as the primary analysis.

RESULTS

The average changes of factors examined were as follows: FIQ score -0.61 ± 5.5 in the waiting-list group and 10.2 ± 14.9 in the CBT group (p = 0.012); WPI -0.33 ± 1.1 in the waiting-list group and 2.4 ± 3.1 in the CBT group (p = 0.002); serum IL-6 level -0.05 ± 0.86 pg/ml in the waiting-list group and 1.5 ± 2.4 pg/ml in the CBT group (p = 0.002); serum IL-8 level - 0.55 ± 0.2.5 pg/ml in the waiting-list group and 5 ± 5.9 pg/ml in the CBT group (p = 0.002); serum TNF-α level 0.67 ± 1.8 pg/ml in the waiting-list group and 0.7 ± 1.6 pg/ml in the CBT group (p = 0.89).

CONCLUSION

Reductions in proinflammatory cytokines after CBT compared with a waiting-list control group confirm the potential value of these biomarkers as surrogate outcome measures in FM.