Long-term immune-endocrine effects of bereavement: relationships with anxiety levels and mood

Psychological, endocrine and immune parameters were measured over a 6-month period in 14 healthy subjects who underwent an unpredictable acute emotional stress (e.g. sudden death of a loved one) compared with 14 controls who did not. Probands were profoundly stressed as assessed 10 days after bereav...

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Bibliographic Details
Published in:Psychiatry research 2003-12, Vol.121 (2), p.145-158
Main Authors: Gerra, Gilberto, Monti, Daniela, Panerai, Alberto E., Sacerdote, Paola, Anderlini, Roberta, Avanzini, Paola, Zaimovic, Amir, Brambilla, Francesca, Franceschi, Claudio
Format: Article
Language:English
Subjects:
Adaptation, Psychological
Adolescent
Adult
Aged
Anxiety
Anxiety - immunology
Anxiety - psychology
Bereavement
beta-Endorphin - immunology
Biological and medical sciences
Cluster Analysis
Corticotropin
Depression
Depressive Disorder, Major - immunology
Depressive Disorder, Major - psychology
Dexamethasone
Dexamethasone - pharmacokinetics
Female
Fundamental and applied biological sciences. Psychology
Glucocorticoids - pharmacokinetics
Humans
Hydrocortisone
Hydrocortisone - blood
Hydrocortisone - pharmacokinetics
Killer Cells, Natural - immunology
Lymphocytes - immunology
Male
Middle Aged
Mitogens - immunology
Natural killer cells
Neuro-immunomodulation
Personality. Affectivity
Psychological stress
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Stress
Surveys and Questionnaires
Time Factors
β-endorphin
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Summary:Psychological, endocrine and immune parameters were measured over a 6-month period in 14 healthy subjects who underwent an unpredictable acute emotional stress (e.g. sudden death of a loved one) compared with 14 controls who did not. Probands were profoundly stressed as assessed 10 days after bereavement by their scores on the Hamilton Rating Scales of Anxiety and Depression, adrenocorticotropin and cortisol plasma concentrations, and non-suppression in response to dexamethasone. Functional alterations of immune parameters, such as responsiveness of peripheral blood lymphocytes to mitogens, were found 40 days after bereavement. Despite a normal number of circulating lymphocyte subsets, the functional activity of natural killer (NK) cells was markedly reduced at day 40. Changes in the intracellular concentration of β-endorphin in peripheral blood mononuclear cells correlated with anxiety and depression scores. Controls showed no changes in psychometric, endocrine and immune measures during the 6-month study. Cluster analysis revealed two groups of bereaved subjects with different patterns of immune and endocrine changes: (1) Five subjects, characterized by harm-avoidant temperament and long-lasting dysphoric mood, showed reduced responsiveness of peripheral blood lymphocytes to mitogens, decreased NK cell activity and non-suppression in response to dexamethasone that persisted for 6 months. (2) Nine subjects showed significant changes only during the early phase after bereavement. Our data suggest that the immunological consequences of stress do not simply overlap with psychological and endocrine alterations, and are particularly severe and long-lasting in a subgroup of subjects, indicating the importance of individual variability in the capacity to cope with stress.
ISSN:0165-1781
1872-7123
DOI:10.1016/S0165-1781(03)00255-5