Current Perspectives on Immunology and Psychiatry

Abstract

We selectively review recent research findings in the field of psychoimmunology which test the hypotheses that immunological dysfunction may be aetiologically related to mental illnesses such as schizophrenia, and that certain morbid affective states such as depression and other forms of psychosocial distress may be the cause of immunosuppression and through this mechanism affect the outcome of illnesses such as cancer. Our examination of research implicating immunological or infective mechanisms in the aetiology of schizophrenia indicates that most studies have been unable to control for major methodological difficulties but the compatibility of these theories with the dopamine hypothesis suggests that further research attention is warranted. More clearly, there is growing evidence demonstrating a link between depression, other states of psychological distress and immunosuppression, but the clinical significance of these findings remains uncertain. The complex relationship between stress and the outcome of illnesses such as cancer is discussed and the possible implications of these findings for clinical psychiatry are suggested.

Can Elective Lymph Node Dissection Decrease the Frequency and Mortality Rate of Late Melanoma Recurrences?

“…We have found that many of our patients who developed late recurrences previously had been under extreme psychosocial stress secondary to events occurring in their personal lives or careers. The association between psychosocial stress and the immunosuppressive state is not new, 11 and has provided the impetus for holistic cancer wellness centers that work to enhance emotional and mental well-being as a means to improve cancer survival and quality of life. These patients who developed late recurrences may have had subclinical disease that became reactivated when their immune system was weakened by psychological distress.…”

Thyroid function in clinical subtypes of major depression: an exploratory study

“…However, on the contrary there are even more papers supporting the idea of a subclinical thyroid dysfunction, especially in melancholic or refractory patients, possibly of an autoimmune origin [44-55] suggesting that subclinical hypothyroidism may lower the threshold for the occurrence of depression[56], or generally to any mental disorder [57-59]. It is reported that most patients with depression may have alterations in their thyroid function including slight elevation of the serum FT4, blunted TSH response to thyrotropin-releasing hormone (TRH) stimulation[60], and loss of the nocturnal TSH rise and this may reflect brain hypothyroidism in the context of systemic euthyroidism[61].…”

Neopterin measurement provides evidence of altered cell-mediated immunity in patients with depression, but not with schizophrenia

“…A number of studies have now demonstrated immunological changes in groups of schizophrenic patients which could be evidence of viral infection. However, most of these studies suffer from methodological problems, particu-larly failure to take into account the effects of age and institutionalization on the immunological parameters measured (O'Donnell et al 1988). A third hypothesis relating immune function and schizophrenia is that a genetic predisposition to schizophrenia might confer a biological advantage through enhanced immunological competence (Huxley et al 1964;Mellsop et al 1974).…”