Limitation of pro- and anti-inflammatory cytokine analysis to discriminate biological stress effects in patients suffering from chronic psychological distress.

BACKGROUND: Research endeavors aiming to evaluate the effect of prolonged psychological distress on the immune system have been pursed over the past decades. Due to the complexity of the two systems involved, the mental and immune status, a large number of questions still remains to be addressed. AIM: In the present study, we aimed to test if chronic distress is associated with pro- and anti-inflammatory cytokine levels in a well-defined study cohort. METHODS: We recruited 42 inpatients suffering from post-traumatic embitterment disorder (PTED), a condition that has been demonstrated to cause intense and persistent psychological distress. Study participants completed established questionnaires to evaluate stress perception, depression and quality of life before and after psychotherapy, aiming to improve stress coping. Venous blood samples to detect serum levels of pro- and anti-inflammatory cytokines [interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ] were obtained pre- and post-treatment. RESULTS: The psychological assessments showed an increase of quality of life, a decrease of perceived stress and depressive symptoms, between the two groups. These findings are not associated with significant alterations of the cytokine levels before and after treatment. CONCLUSIONS: In our study, the psychological treatment of inpatients suffering from chronic psychological distress does not result in changes in cytokine levels. Further research with a broader analysis of immune markers and enhanced detection methods may be required to unveil psycho-immunological association in PTED patients.

Common laboratory measures of global health may not be suited to assess, discriminate or predict chronic stress effects on biological systems.

BACKGROUND: There is a longstanding discussion that prolonged psychological stress can have negative somatic effects, especially in respect to endocrinological and immunological changes. Yet, the clinical significance of these findings is still unclear. Patients with prolonged stress should show more signs and symptoms of related illnesses. AIM: The question we like to answer in this study is: are laboratory measures of global health suited to assess, discriminate or predict chronic psychological stress effects on biological systems? METHODS: Included were 50 inpatients who were suffering from post-traumatic embitterment disorder (PTED), a condition that causes persistent and intense psychological distress. They were compared with a group of 50 matched control patients with unselected psychosomatic disorders but no immediate stress and strain. Gender distribution and age were the same in both samples because of the matching (60% women; mean age: 49 years). PTED patients had an average duration of illness of 31.7 (±35.5) months. In the SCL-90 they showed an average GSI score of 1.13 (±0.55) compared with 0.74 (±0.50) in the controls, as indicator of their increased psychological strain. Between groups, we compared the results of 24 laboratory tests, which can be seen as indicators of functioning of all important body systems. RESULTS: There was no significant difference in the results of laboratory tests between groups and especially no indicators for different rates of immunological or inflammatory illnesses. CONCLUSION: Laboratory measures of global health may not be suited to assess, discriminate or predict psychological chronic stress effects on important biological systems.