1
|
Cvitanović H, Milošević M, Bukvić-Bešlić I, Lugović-Mihić L. Determination of Psychological Stress, Serum Immune Parameters, and Cortisol Levels in Patients With Human Papilloma Virus. Clin Ther 2020; 42:783-799. [PMID: 32340917 DOI: 10.1016/j.clinthera.2020.03.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Because the results of studies investigating the relation between human papilloma virus (HPV) infection and the effects of psychological stress are inconsistent, this study was conducted to expand on previous research by analyzing patient stress levels, serum immune parameters, and cortisol levels in patients with clinical HPV manifestations. It also looked for differences in clinical manifestations of HPV depending on patient level of experienced stress. METHODS This cross-sectional study included 213 subjects (94 women and 119 men aged ≥18 years; average age, 41 years) with clinical manifestations of HPV infection (165 subjects with extragenital manifestations and 48 with genital manifestations) who were treated at the Department of Dermatovenerology, Karlovac General Hospital, from January 1, 2012, to December 31, 2015. Psychological, neurohormonal and immune parameters (serum values of leukocytes, alpha2-globulins, beta-globulins, albumins, and proteins), and serum cortisol levels were analyzed. Questionnaires were used to determine patients' perception of stress: the Recent Life Changes Questionnaire, the Perceived Stress Scale, and the Brief Cope Test. One group of subjects had confirmed stressful experiences, defined by the Recent Life Changes Questionnaire as a period of 1 year with at least 500 life change units; the control group included patients with no significant stressful experiences. FINDINGS Patients with confirmed significant stress experience had a statistically significant higher degree of perception of stress. There were no statistically significant differences in terms of the impact of stress on clinical HPV manifestations (genital and extragenital), sex, lesional duration, or recurrence. In patients with significant stress experience, significantly higher values of leukocytes (6.68 × 109/L), alpha2-globulins (6.85 g/L), and beta-globulins (7.33 g/L) were observed. Adaptive coping and a lower perception of stress significantly reduced the chances of having extragenital manifestations by 2.63 times. A higher perception of stress significantly increased the likelihood of genital manifestations. IMPLICATIONS Although this study found that stress increased the values of leukocytes, alpha2-globulins, and beta-globulins, no evidence was found that it affected clinical manifestations of HPV infection. The redundancy of the immune system could account for this finding. This study is among the first to investigate the correlation between psychological, neurohormonal, and immune indicators of stress.
Collapse
Affiliation(s)
- Hrvoje Cvitanović
- Department of Dermatovenerology, Karlovac General Hospital, Karlovac, Croatia
| | - Milan Milošević
- University of Zagreb, School of Medicine, Andrija Stampar School of Public Health, Department for Environmental Health, Occupational and Sports Medicine, Zagreb, Croatia
| | - Iva Bukvić-Bešlić
- Clinical Department of Dermatovenerology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Liborija Lugović-Mihić
- Clinical Department of Dermatovenerology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
| |
Collapse
|
2
|
Reingle Gonzalez JM, Jetelina KK, Olague S, Wondrack JG. Violence against women increases cancer diagnoses: Results from a meta-analytic review. Prev Med 2018; 114:168-179. [PMID: 29981792 DOI: 10.1016/j.ypmed.2018.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/26/2018] [Accepted: 07/04/2018] [Indexed: 11/16/2022]
Abstract
The purpose of this project was to assess the magnitude of the relationship between violence against women and cancer; to identify the exposures and cancers for which this relationship was particularly robust; to identify the effect of violence exposure on cancer screening. We conducted a meta-analysis of 36 studies to determine the relationship between violence against women and cancer outcomes, including screening, in 2017. Results from this review provide evidence of a significant, positive relationship between violence and cancer diagnoses, particularly for cervical cancer. Women who were victims of intimate partner violence and sexual abuse were more likely to be diagnosed with cancer compared with non-victims. Violence against women did not appear to be related to cancer screening practices and routine clinical service utilization; however, violence was associated with greater odds of abnormal pap test results. Victims of intimate partner violence and women who suffered physical abuse were more likely to have abnormal pap test results. In conclusion, use of screening tools for violence against women in clinical settings may improve the breadth and quality of research on violence against women and cancer. Investigators should consider how to creatively apply case-control and retrospective cohort designs to investigate the complex mechanisms and moderators of the relationship between violence against women and cancer.
Collapse
Affiliation(s)
- Jennifer M Reingle Gonzalez
- University of Texas School of Public Health, Department of Epidemiology, Human Genetics and Environmental Sciences, United States of America.
| | - Katelyn K Jetelina
- University of Texas School of Public Health, Department of Epidemiology, Human Genetics and Environmental Sciences, United States of America
| | - Stefany Olague
- University of Texas School of Public Health, Department of Epidemiology, Human Genetics and Environmental Sciences, United States of America
| | - Jordan G Wondrack
- University of Texas School of Public Health, United States of America
| |
Collapse
|
3
|
de Abreu MS, Giacomini ACVV, Zanandrea R, Dos Santos BE, Genario R, de Oliveira GG, Friend AJ, Amstislavskaya TG, Kalueff AV. Psychoneuroimmunology and immunopsychiatry of zebrafish. Psychoneuroendocrinology 2018; 92:1-12. [PMID: 29609110 DOI: 10.1016/j.psyneuen.2018.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/14/2018] [Accepted: 03/21/2018] [Indexed: 12/11/2022]
Abstract
Despite the high prevalence of neural and immune disorders, their etiology and molecular mechanisms remain poorly understood. As the zebrafish (Danio rerio) is increasingly utilized as a powerful model organism in biomedical research, mounting evidence suggests these fish as a useful tool to study neural and immune mechanisms and their interplay. Here, we discuss zebrafish neuro-immune mechanisms and their pharmacological and genetic modulation, the effect of stress on cytokines, as well as relevant models of microbiota-brain interplay. As many human brain diseases are based on complex interplay between the neural and the immune system, here we discuss zebrafish models, as well as recent successes and challenges, in this rapidly expanding field. We particularly emphasize the growing utility of zebrafish models in translational immunopsychiatry research, as they improve our understanding of pathogenetic neuro-immune interactions, thereby fostering future discovery of potential therapeutic agents.
Collapse
Affiliation(s)
- Murilo S de Abreu
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil; Postgraduate Program in Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil; The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA, USA
| | - Ana C V V Giacomini
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil; Postgraduate Program in Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil; Postgraduate Program in Environmental Sciences, University of Passo Fundo (UPF), Passo Fundo, Brazil
| | - Rodrigo Zanandrea
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Bruna E Dos Santos
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | - Rafael Genario
- Bioscience Institute, University of Passo Fundo (UPF), Passo Fundo, RS, Brazil
| | | | - Ashton J Friend
- Tulane University School of Science and Engineering, New Orleans, LA, USA
| | - Tamara G Amstislavskaya
- Research Institute of Physiology and Basic Medicine SB RAS, and Department of Neuroscience, Novosibirsk State University, Novosibirsk, Russia
| | - Allan V Kalueff
- School of Pharmacy, Southwest University, Chongqing, China; Ural Federal University, Ekaterinburg, Russia; ZENEREI Research Center, Slidell, LA, USA; Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia; Institute of Experimental Medicine, Almazov National Medical Research Center, St. Petersburg, Russia; Russian Research Center for Radiology and Surgical Technologies, Pesochny, Russia; Laboratory of Translational Biopsychiatry, Research Institute of Physiology and Basic Medicine SB RAS, Novosibirsk, Russia.
| |
Collapse
|
4
|
Kosenko KA, Craig E, Harvey-Knowles J. Helpful and challenging support encounters in the aftermath of HPV infection and diagnosis. Issues Ment Health Nurs 2012; 33:355-62. [PMID: 22646199 DOI: 10.3109/01612840.2012.671440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Infection and diagnosis with HPV create significant support needs, yet the support experiences and evaluations of women with HPV remain unexplored. This study identified supportive communication behavior perceived as helpful or problematic by women with HPV. Interviews with 25 participants revealed that women find it helpful when supportive others: (a) provide reassurance, information, and validation; (b) attend appointments; (c) facilitate reappraisals; and, (d) listen. Findings also highlighted support challenges, such as disclosure difficulties and problems locating and accessing support groups. The discussion focuses on explanations for and implications of variations in enacted support quality for women with HPV and others managing chronic illnesses.
Collapse
Affiliation(s)
- Kami A Kosenko
- North Carolina State University, Raleigh, NC 27695, USA.
| | | | | |
Collapse
|
5
|
Kosenko KA, Hurley RJ, Harvey JA. Sources of the uncertainty experienced by women with HPV. QUALITATIVE HEALTH RESEARCH 2012; 22:534-545. [PMID: 22068044 DOI: 10.1177/1049732311424404] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Women with genital human papillomavirus (HPV) experience considerable stress and uncertainty as a result of the diagnosis; however, little is known about the sources of uncertainty in HPV. Given that uncertainty creates stress, which might be linked to the pathogenesis of cervical cancer, research on these sources of uncertainty is warranted. To this end, we completed semistructured interviews with 25 women living with HPV, and identified seven sources of uncertainty: The meaning of the diagnosis, the potential for disease progression, finances, the source of the infection, disclosure, sex and reproduction, and the HPV vaccine. In the discussion we articulate the relevance and importance of study findings to research, theory, and practice.
Collapse
Affiliation(s)
- Kami A Kosenko
- North Carolina State University, Raleigh, North Carolina 27695, USA.
| | | | | |
Collapse
|
6
|
Coker AL, Hopenhayn C, DeSimone CP, Bush HM, Crofford L. Violence against Women Raises Risk of Cervical Cancer. J Womens Health (Larchmt) 2009; 18:1179-85. [PMID: 19630537 DOI: 10.1089/jwh.2008.1048] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND An emerging literature suggests that violence against women (VAW), particularly sexual violence, may increase the risk of acquiring a sexually transmitted infection (STI) and, therefore, may be associated with cervical cancer development. The purpose of this cross-sectional analysis was to determine if women who had experienced violence had higher prevalence rates of invasive cervical cancer. METHODS Women aged 18-88 who joined the Kentucky Women's Health Registry (2006-2007) and completed a questionnaire were included in the sample. Multivariate logistic regression analyses were used to adjust odds ratio (OR) for confounders (e.g., age, education, current marital status, lifetime illegal drug use, and pack-years of cigarette smoking). RESULTS Of 4732 participants with no missing data on violence, cervical cancer, or demographic factors, 103 (2.1%) reported ever having cervical cancer. Adjusting for demographic factors, smoking, and illegal drug use, experiencing VAW was associated with an increased prevalence of invasive cervical cancer (adjusted OR [aOR] = 2.6, 95% CI = 1.7-3.9). This association remained significant when looking at three specific types of VAW: intimate partner violence (IPV) (aOR = 2.7, 95% CI = 1.8-4.0), adult exposure to forced sex (aOR = 2.6, 95% CI = 1.6-4.3), and child exposure to sexual abuse (aOR = 2.4, 95% CI = 1.4-4.0). CONCLUSIONS Rates of cervical cancer were highest for those experiencing all three types of VAW relative to those never experiencing VAW. Because VAW is common and has gynecological health effects, asking about VAW in healthcare settings and using this information to provide tailored healthcare may improve women's health outcomes.
Collapse
Affiliation(s)
- Ann L Coker
- Department of Obstetrics and Gynecology, University of Kentucky, Lexington, KY 40536-0293, USA.
| | | | | | | | | |
Collapse
|
7
|
Biological, psychological and behavioral, and social variables influencing colorectal cancer screening in African Americans. Nurs Res 2009; 58:312-20. [PMID: 19752671 DOI: 10.1097/nnr.0b013e3181ac143d] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Provider recommendation of colorectal cancer (CRC) screening is an important predictor of screening in African Americans. Little is known about influences of screening in African Americans without provider recommendations. OBJECTIVES The objectives of this study were to test, using the biopsychosocial (BPS) model, the relative predictive strength for screening of variables grouped into biological, psychological and behavioral, and social system factors and to compare CRC screening predictors in African Americans with and without provider recommendations. METHODS Secondary analysis of the 2002 Maryland Cancer Survey data was done using (a) hierarchical logistic regression to examine the relative influence of factors on screening and (b) simultaneous logistic regression to examine predictors of screening in individuals with and without provider recommendations to screen. Factors included biological (age and gender), psychological and behavioral (mammogram, prostate specific antigen, body mass index, activity level, fruit and vegetable consumption, alcohol, smoking, and cancer perceptions), and social system (education, employment, insurance, and healthcare provider access). RESULTS The social system factor influenced CRC screening in the overall sample (n = 492). In African Americans with provider recommendations (n = 337), the very active were 2.43 (95% confidence interval [CI] = 1.11-5.28) times more likely to screen than were less active. Insured were 3.25 (95% CI = 1.14-9.31) times more likely to screen than were uninsured. In African Americans without provider recommendations (n = 155), 65- to 69-year-olds were 9.99 (95% CI = 2.31-43.32) times more likely to screen than were those 50- to 54-year-olds without screening. DISCUSSION The BPS model confirms social system factor strength in influencing CRC screening in African Americans. Identifying other social system variables that enhance healthcare provider access is critical to increase provider visits, which will generate recommendations and subsequent CRC screening.
Collapse
|
8
|
Wilkerson JE, Bailey JM, Bieniasz ME, Murray SI, Ruffin MT. Psychosocial factors in risk of cervical intraepithelial lesions. J Womens Health (Larchmt) 2009; 18:513-8. [PMID: 19361319 DOI: 10.1089/jwh.2008.0982] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study examines the relationship among psychosocial factors, behavioral risks for abnormal cervical cytology, and abnormal cervical cytology. METHODS A self-administered questionnaire was used to measure perceived stress, discrimination, lifetime stressful events, optimism, social support, and psychological state. Women with normal Pap smears attending a primary care clinic and women attending a colposcopy clinic because of an abnormal Pap smear were eligible. The scores between the two groups were compared. RESULTS A total of 265 women participated in the study. There were no significant relationships between psychosocial factors and cervical cytology status. In a regression model, age (B = -0.057, p = 0.001) was predictive of having abnormal cervical cytology. Smoking was correlated with an increased family Apgar score (p = 0.021), Perceived Stress Scale (PSS) score (p = 0.049), and Revised Life Stressor Checklist score (p < 0.001). A higher mean number of lifetime male partners was related to increased family Apgar score (p = 0.012), Revised Life Stressor Checklist score (p < 0.001), and major event discrimination (p < 0.001). Earlier age at coitarche was associated with increased family Apgar score (p < 0.001). CONCLUSIONS These results do not support that psychosocial factors play a role in the risk of developing abnormal cervical cytology. Behavioral risks for developing abnormal cervical cytology are associated with life stressors, family function, and perceived discrimination.
Collapse
Affiliation(s)
- Jennifer E Wilkerson
- Midwestern University, Arizona College of Osteopathic Medicine, Glendale, Arizona, USA
| | | | | | | | | |
Collapse
|
9
|
Monti DA, Sufian M, Peterson C. Potential role of mind-body therapies in cancer survivorship. Cancer 2008; 112:2607-16. [DOI: 10.1002/cncr.23443] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
10
|
Tiersma ESM, van der Lee ML, Garssen B, Peters AAW, Visser AP, Fleuren GJ, van Leeuwen KM, le Cessie S, Goodkin K. Psychosocial factors and the course of cervical intra-epithelial neoplasia: a prospective study. Gynecol Oncol 2005; 97:879-86. [PMID: 15894367 DOI: 10.1016/j.ygyno.2005.03.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2004] [Revised: 12/24/2004] [Accepted: 03/02/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the influence of psychosocial factors on the course of cervical intra-epithelial neoplasia (CIN). METHODS A group of 93 patients with CIN 1 or 2 was followed for 2.25 years by half-yearly colposcopy and cytology. Negatively-rated life events, social support, and coping style were studied in relation to distress during follow-up and in relation to time till progression and regression of CIN. Human papillomavirus (HPV) infection was controlled for as well as sick role bias caused by suspicion of having cervical cancer and distress due to the abnormal cervical smear. RESULTS During follow-up, progression was found in 20 patients (22%), stable disease in 22 patients (24%), and regression in 51 patients (55%). Negatively-rated life events and lack of social support predicted distress longitudinally. No association was found between progression or regression of CIN and negatively-rated life events, lack of social support, coping style, and distress. CONCLUSION We found no evidence that psychosocial factors influence the course of CIN.
Collapse
Affiliation(s)
- E S M Tiersma
- Helen Dowling Institute, Center for Psycho-oncology, Utrecht, The Netherlands.
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Tiersma ESM, van der Lee ML, Peters AAW, Visser AP, Jan Fleuren G, Garssen B, van Leeuwen KM, le Cessie S, Goodkin K. Psychosocial factors and the grade of cervical intra-epithelial neoplasia: a semi-prospective study. Gynecol Oncol 2004; 92:603-10. [PMID: 14766254 DOI: 10.1016/j.ygyno.2003.10.046] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2003] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To study the influence of psychosocial factors on the grade of cervical intra-epithelial neoplasia. METHODS The influence of psychosocial factors on the grade of cervical intra-epithelial neoplasia (CIN) was studied in a group of 342 patients with an abnormal cervical smear. Participants completed a set of questionnaires after colposcopy directed biopsy before knowing the biopsy result. Negatively rated life events, social support, and coping style were studied in relation to distress and grade of CIN. Infection with human papillomavirus (HPV) types was controlled for, as well as sick role bias caused by suspicion of having cervical cancer and distress due to the abnormal cervical smear. RESULTS Negatively rated life events, lack of social support, and emotional coping were significant predictors for level of distress. No significant relationship was found, however, between the psychosocial factors and grade of CIN. CONCLUSION No support was found for an influence of negatively rated life events, social support, coping style, and distress on grade of CIN.
Collapse
|
12
|
Abstract
OBJECTIVE We assessed the association between psychosocial stress and preinvasive cervical neoplasia development controlling for HR-HPV infection. METHODS This case-control study enrolled low-income women receiving family planning services at health department clinics. There were 59 cases with biopsy confirmed HSIL and 163 with low-grade SIL and 160 controls with normal cervical cytology. A modified SLE scale was used to measure stressful events and the perceived impact of the event in the prior 5 years. Unconditional logistic regression was used to assess SIL risk and stressful events scores and by subscales. RESULTS After adjusting for age, HR-HPV infection, and lifetime number of sex partners, the SLE count score was associated with an increased risk of SIL among white women (aOR = 1.20; 95% CI = 1.04, 1.38) yet not among African American women (aOR = 1.02; 95% CI = 0.87, 1.19). The relationship stress subscale (divorce, infidelity, an increase in the number of arguments, and psychological and physical partner violence) was the only one of four subscales (loss, violence, and financial stress) associated with SIL, again, only among white women (aOR = 1.54; 95% CI = 1.21, 1.96). CONCLUSIONS These data suggest that psychosocial stress may play a role in SIL development. Future studies are needed to confirm these findings, to explore racial difference in reporting stress, and to explore the mechanism through which psychosocial stress may affect cervical neoplasia risk.
Collapse
Affiliation(s)
- Ann L Coker
- Department of Epidemiology, University of Texas School of Public Health, Houston, Texas 77225, USA.
| | | | | | | | | |
Collapse
|
13
|
Abstract
The wide-ranging effects of prostate cancer can be an emotional burden to the patient and his family. Recognizing important periods during the diagnosis and treatment that can be particularly stressful, the symptoms indicating patients are at high risk for emotional distress, and the signs and symptoms of emotional distress can encourage improved communication, education, treatment, and referral to minimize the effects of the emotional distress.
Collapse
Affiliation(s)
- Michael A Burke
- Mental Health Service Line, Atlanta Veterans Affairs Medical Center, 1670 Clairmont Road (116), Decatur, Georgia 30033, USA.
| | | | | |
Collapse
|
14
|
Turner-Cobb JM. Psychological and neuroendocrine correlates of disease progression. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2003; 52:353-81. [PMID: 12498111 DOI: 10.1016/s0074-7742(02)52016-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Affiliation(s)
- Julie M Turner-Cobb
- Department of Psychology, University of Kent at Canterbury, Canterbury, Kent CT2 7NP, United Kingdom
| |
Collapse
|
15
|
Abstract
Psychoneuroimmunology (PNI) is a rapidly evolving multidisciplinary field founded on the premise that psychosocial factors, the central nervous system, and the immune system are intimately linked. Following publication of scientific evidence supporting this link, a number of animal and human studies have been published, both inside and outside the area of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome. These studies support the existence of bidirectional feedback mechanisms operating between the brain and the immune system. To date, however, there is no all-encompassing model that predicts individual differences in the relationship among psychosocial factors, immunologic measures, and clinical disease progression in HIV type 1 (HIV-1) infection. This variability in human response has been explained by a number of cofactors (host as well as environmental) that appear to accelerate the course of the disease. Since psychosocial factors are highly amenable to behavioral interventions, several models for intervention research have been proposed to evaluate whether such interventions can enhance immune functioning, thereby curtailing disease progression. Examination of these interventions in the context of PNI and HIV-1 infection, however, is rather limited. Therefore, researchers and clinicians must not only consider conceptualizations and paradigms in this area of research, but also focus on empirically testable, theory-driven models that allow for the unique characteristics of individual patients.
Collapse
|
16
|
Savard J, Miller SM, Mills M, O'Leary A, Harding H, Douglas SD, Mangan CE, Belch R, Winokur A. Association between subjective sleep quality and depression on immunocompetence in low-income women at risk for cervical cancer. Psychosom Med 1999; 61:496-507. [PMID: 10443758 DOI: 10.1097/00006842-199907000-00014] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate whether subjective sleep quality is more strongly associated with immunocompetence than depression among women at risk for cervical cancer. METHODS Participants were 91 women referred for colposcopy because of abnormal results on a Pap smear. On the day of the procedure. participants completed the Center for Epidemiological Studies Depression Scale, two indices of subjective sleep quality (ie, satisfaction with sleep obtained and degree of sleep restfulness), and a health behaviors assessment questionnaire. Levels of peripheral blood lymphocyte subpopulations (helper T, cytotoxic/suppressor T, NK, and B cells) were also assessed at this time. Approximately 10 days later, the presence of depressive disorder was assessed using the Structured Clinical Interview for DSM-III-R. RESULTS Hierarchical regression analyses revealed that satisfaction with the amount of sleep obtained was significantly associated with the circulating number and percentage of helper T cells (T(H)/CD4+) and the percentage of cytotoxic/suppressor T cells (T(C)/CD8+), after controlling for confounder variables (ie, age, smoking status, and drug use). Depression was significantly associated only with the percentage of T(C) cells. Sleep satisfaction remained significantly associated with the number and percentage of T(H) cells and percentage of T(C) cells after controlling for the variance explained by depression. CONCLUSIONS Results of this study suggest that subjective sleep quality shares a significant and independent portion of the variance with immunity that is not accounted for by depression. Although the long-term impact of these immune alterations on disease progression needs to be directly explored, it may be important to systematically screen for and manage sleep disturbance in women at high risk for cervical cancer.
Collapse
Affiliation(s)
- J Savard
- Fox Chase Cancer Center, Philadelphia 19012, PA, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Byrnes DM, Antoni MH, Goodkin K, Efantis-Potter J, Asthana D, Simon T, Munajj J, Ironson G, Fletcher MA. Stressful events, pessimism, natural killer cell cytotoxicity, and cytotoxic/suppressor T cells in HIV+ black women at risk for cervical cancer. Psychosom Med 1998; 60:714-22. [PMID: 9847030 DOI: 10.1097/00006842-199811000-00009] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examines whether stressful negative life events and pessimism were associated with lower natural killer cell cytotoxicity (NKCC) and T cytotoxic/suppressor cell (CD8+CD3+) percentage in black women co-infected with human immunodeficiency virus Type 1 (HIV-1) and human papillomavirus (HPV), a viral initiator of cervical cancer. METHOD Psychosocial interviews, immunological evaluations, and cervical swabs for HPV detection and subtyping were conducted on 36 HIV+ African-American, Haitian, and Caribbean women. RESULTS Greater pessimism was related to lower NKCC and cytotoxic/suppressor cells after controlling for presence/absence of HPV Types 16 or 18, behavioral/lifestyle factors, and subjective impact of negative life events. CONCLUSIONS A pessimistic attitude may be associated with immune decrements, and possibly poorer control over HPV infection and increased risk for future promotion of cervical dysplasia to invasive cervical cancer in HIV+ minority women co-infected with HPV.
Collapse
Affiliation(s)
- D M Byrnes
- Department of Psychology, University of Miami, Coral Gables, Florida 33124, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Fujimura RK, Shapshak P, Segal DM, Crandall KA, Goodkin K, Page JB, Douyon R, Zhang BT, Xin KQ, Rodriguez de la Vega P, Nagona I, Srivastava A. Viral and host determinants of neurovirulence of HIV-1 infection. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1998; 437:241-53. [PMID: 9666277 DOI: 10.1007/978-1-4615-5347-2_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- R K Fujimura
- Dept. of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, FL 33136, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Abstract
An enduring state of exhaustion as opposed to chronic hostility-a long-term risk factor-has been found to be a more proximal precursor of myocardial infarction. The strength of the association with exhaustion suggests that this behavioral factor reflects not only a breakdown in adaptation to chronic stressors but also the disease process itself. Recent research on the pathogenesis of myocardial infarction lends credence to a role for immunological factors. herein, we outline a two-stage theoretical model, postulating a feedback relationship between behavior, associated neuroendocrine changes, immunological responses, and the pathogenesis of this disease. We propose a long-term first stage consisting of chronic hostility, prolonged occupational over-exertion, and exposure to other life stressors, terminating eventually in a much shorter second stage of 'vital exhaustion'. Stressor-associated neuroendocrine changes result in immunosuppression leading to reactivation of latent, systemic infections (such as cytomegalovirus) and potentially to autoimmune reactions as well. The consequent release of pro-inflammatory cytokines exacerbates fatigue and induces a stimulus for cytokine production in brain. This cytokine production stimulates a chronically activated, over-compensated limbic-hypothalamic-pituitary-adrenal axis, resulting in a dampened response, continued exhaustion, and a potential 'reverberating circuit' between behavior, neuroendocrine change, cytokine release and coronary artery occlusion, culminating in myocardial infarction.
Collapse
Affiliation(s)
- K Goodkin
- Department of Psychiatry, University of Miami School of Medicine, FL 33136, USA.
| | | |
Collapse
|
20
|
Max MB. Thirteen consecutive well-designed randomized trials show that antidepressants reduce pain in diabetic neuropathy and postherpetic neuralgia. ACTA ACUST UNITED AC 1995. [DOI: 10.1016/s1082-3174(11)80029-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
21
|
Goodkin K, Antoni MH, Sevin B, Fox BH. A partially testable, predictive model of psychosocial factors in the etiology of cervical cancer i. Biological, psychological and social aspects. Psychooncology 1993. [DOI: 10.1002/pon.2960020203] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
22
|
Goodkin K, Antoni MH, Sevin B, Fox BH. A partially testable, predictive model of psychosocial factors in the etiology of cervical cancer ii. bioimmunological, psychoneuroimmunological, and socioimmunological aspects, critique and prospective integration. Psychooncology 1993. [DOI: 10.1002/pon.2960020204] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|