Chronic inflammation and oxidative stress have been implicated in the pathophysiology of
Major Depressive Disorder (MDD), as well as in a number of chronic medical conditions. The aim of
this study was to examine the relationship between peripheral inflammatory and oxidative stress
markers in un-medicated subjects with MDD compared to non-depressed healthy controls and compared to
subjects with MDD after antidepressant treatment. We examined the relationships between IL-6, IL-10,
and the IL-6/IL-10 inflammatory ratio vs. F2-isoprostanes (F2-IsoP), a marker of oxidative stress,
in un-medicated MDD patients (n = 20) before and after 8 weeks of
open-label sertraline treatment (n = 17), compared to healthy non-depressed
controls (n = 20). Among the un-medicated MDD subjects, F2-IsoP
concentrations were positively correlated with IL-6 concentrations (p < 0.05)
and were negatively correlated with IL-10 concentrations (p < 0.01).
Accordingly, F2-IsoP concentrations were positively correlated with the ratio of IL-6/IL-10
(p < 0.01). In contrast, in the control group, there were no significant
correlations between F2-IsoPs and either cytokine or their ratio. After MDD subjects were treated
with sertraline for 8 weeks, F2-IsoPs were no longer significantly correlated with IL-6, IL-10 or
the IL-6/IL-10 ratio. These data suggest oxidative stress and inflammatory processes are positively
associated in untreated MDD. Our findings are consistent with the hypothesis that the homeostatic
buffering mechanisms regulating oxidation and inflammation in healthy individuals become
dysregulated in untreated MDD, and may be improved with antidepressant treatment. These findings may
help explain the increased risk of comorbid medical illnesses in MDD.
Objective: Limited research in Taiwan and Europe suggest that hope is inversely correlated with certain dimensions of the pain experience. However, the relationship between hope and pain among oncology outpatients in the United States has not been evaluated. The aims of this study were to investigate the relationship between hope and cancer pain, after accounting for key psychological, demographic, and clinical characteristics. Design: We enrolled a convenience sample of 78 patients who were receiving concurrent oncologic and symptom-focused care in a comprehensive cancer center. Patient demographic and clinical information was obtained from patient report and medical record review. Patients completed the Herth Hope Index, the Brief Pain Inventory, the Hospital Anxiety and Depression Scale, and the Steinhauser Spiritual Concern Probe. Results: Levels of hope were not associated with age, gender, or the presence of metastatic disease. Herth Hope Index scores were negatively correlated with average pain intensity (p = 0.02), worst pain intensity (p < 0.01), pain interference with function (p < 0.05), anxiety (p < 0.01), and depression (p < 0.01), and were positively correlated with spiritual well-being scores (p < 0.01). However, after controlling for depression and spiritual wellbeing with regression analysis, the relationship between pain intensity and hope was no longer significant. Conclusions: While an association exists between the patients' experience of pain and levels of hope in this study, adjustment for depression and spiritual well being eliminates the relationship initially observed. Although the causal relationships have yet to be determined, in our study hope had a stronger connection to psycho-spiritual factors, than to pain experiences or severity.
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