Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-12T22:04:01.682Z Has data issue: false hasContentIssue false

14 - Depression and immunity: biological and behavioural mechanisms

from Part 3 - Biological and behavioural processes

Published online by Cambridge University Press:  17 September 2009

By
Michael Irwin
Edited by
Andrew Steptoe
Michael Irwin
Affiliation:
Cousins Center for Psychoneuroimmunology, UCLA Neuropsychiatric Institute, University of California, Los Angeles, Los Angeles, CA, USA
Andrew Steptoe
Affiliation:
University College London
Get access

Summary

Introduction

Depression has a huge impact on individuals and society, with a lifetime prevalence of over 15%. By 2020, depression will be the second leading illness in the world, as projected by the World Health Organization (WHO). In addition to the emotional consequences of depression, the disorder is increasingly implicated in a wide range of medical conditions. Moreover, a growing body of evidence indicates that depression, including even minor depression, has notable immunological consequences. It is important therefore to consider possible immune mechanisms in the detrimental effects of depression on health, particularly in vulnerable individuals such as elderly people and patients with chronic disease.

This chapter provides a review of the research being conducted on the relationship between depression and immunity, beginning with an overview of the clinical importance of depressive disorders for mortality risk. The various immune alterations that occur during depression are examined, with discussion of the role of autonomic, neuroendocrine and behavioural (e.g., sleep) mechanisms. The chapter concludes with consideration of the clinical implications of immune changes in depression for several medical disorders.

Clinical characteristics of depression

Definition of depression

Depression can be defined as a condition that primarily entails a disturbance of mood; this affective disturbance is often characterised by a mood that is sad, hopeless, discouraged or simply depressed [1].

Keywords

behavioural mechanismsbiological mediatorsclinical psychoneuroimmunologydepressionmortality risknatural killer cellsimmunityhypothalamic-pituitary adrenal axis
Type
Chapter
Information
Depression and Physical Illness , pp. 299 - 320
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th edn (Washington, DC: American Psychiatric Association, 2000).
Rapaport, M. H., Judd, L. L., Schettler, P. J., et al., A descriptive analysis of minor depression. Am. J. Psychiatry 159 (2002), 637–43.Google Scholar
Berger, A. K., Small, B. J., Forsell, Y., Backman, L., Preclinical symptoms of major depression in very old age: a prospective longitudinal study. Am. J. Psychiatry 155 (1998), 1039–43.Google Scholar
Lyness, J. M., Caine, E. D., Conwell, Y., King, D., Depressive symptoms, medical illness, and functional status in depressed psychiatric inpatients. Am. J. Psychiatry 150 (1993), 910–15.Google Scholar
Hays, R. D., Wells, K. B., Sherbourne, C. D., Rogers, W., Spritzer, K., Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch. Gen. Psychiatry 52 (1995), 11–19.Google Scholar
Wulsin, L. R., Vailant, G. E., Wells, V. E., A systematic review of the mortality of depression. Psychosom. Med. 61 (1999), 6–17.Google Scholar
Bruce, M. L., Leaf, P. J., Rozal, G. P., Florio, L., Hoff, R. A., Psychiatric status and 9-year mortality data in the New Haven Epidemiologic Catchment Area Study. Am. J. Psychiatry 151 (1994), 716–21.Google Scholar
Herrmann, C., Brand-Driehorst, S., Kaminsky, B., et al., Diagnostic groups and depressed mood as predictors of 22-month mortality in medical inpatients. Psychosom. Med. 60 (1998), 570–77.Google Scholar
Rovner, B. W., Depression and increased risk of mortality in the nursing home patient. Am. J. Med. 94 (1993), 19–22S.Google Scholar
Frasure-Smith, N., Lespérance, F., Talajic, M., Depression following myocardial infarction: impact on 6-month survival. J. Am. Med. Assoc. 270 (1993), 1819–25.Google Scholar
Frasure-Smith, N., Lespérance, F., Talajic, M., The impact of negative emotions on prognosis following myocardial infarction: is it more than depression?Health Psychol. 14 (1995), 388–98.Google Scholar
Dew, M. A., Hoch, C. C., Buysse, D. J., et al., Healthy older adults' sleep predicts all-cause mortality at 4 to 19 years of follow-up. Psychosom. Med. 65 (2003), 63–73.Google Scholar
Kripke, D. F., Garfinkel, L., Wingard, D. L., Klauber, M. R., Marler, M. R., Mortality associated with sleep duration and insomnia. Arch. Gen. Psychiatry 59 (2002), 131–6.Google Scholar
D. Gottlieb, D. Schulman, B. Nam, R. Agostino, W. Kannel, Sleep duration predicts mortality: the Framingham study. Presented at the 16th Annual Meeting of the Associated Professional Sleep Societies, 8–13 June 2002, Seattle, WA.
Newman, A. B., Spiekerman, C. F., Enright, P., et al., Daytime sleepiness predicts mortality and cardiovascular disease in older adults: the Cardiovascular Health Study Research Group. J. Am. Geriatr. Soc. 48 (2000), 115–23.Google Scholar
Owens, M. J., Nemeroff, C. B., Physiology and pharmacology of corticotropin-releasing factor. Pharmacol. Rev. 91 (1991), 425–73.Google Scholar
Friedman, E. M., Irwin, M. A., A role for CRH and the sympathetic nervous system in stress-induced immunosuppression. Ann. N. Y. Acad. Sci. 771 (1995), 396–418.Google Scholar
Friedman, E. M., Irwin, M. R., Modulation of immune cell function by the autonomic nervous system. Pharmacol. Ther. 74 (1997), 27–38.Google Scholar
Irwin, M., Vale, W., Rivier, C., Central corticotropin-releasing factor mediates the suppressive effect of stress on natural killer cytotoxicity. Endocrinology 126 (1990), 2837–44.Google Scholar
Irwin, M., Brain corticotropin releasing hormone- and interleukin-1 β-induced suppression of specific antibody production. Endocrinology 133 (1993), 1352–60.Google Scholar
Irwin, M., Brown, M., Patterson, T., et al., Y. Neuropeptide and natural killer cell activity: findings in depression and Alzheimer caregiver stress. FASEB J. 5 (1991), 3100–107.Google Scholar
Sanders, V. M., Straub, R. H., Norepinephrine, the beta-adrenergic receptor, and immunity. Brain Behav. Immun. 16 (2002), 290–332.Google Scholar
J. A. Moynihan, S. Y. Stevens, Mechanisms of stress-induced modulation of immunity in animals. In Psychoneuroimmunology, ed. Ader, R., Felten, D. L., Cohen, N. (San Diego, CA: Academic Press, 2001), pp. 227–50.
Dhabhar, F. S., Miller, A. H., McEwen, B. S., Spencer, R. L., Stress-induced changes in blood leukocyte distribution: role of adrenal steroid hormones. J. Immunol. 157 (1996), 1638–44.Google Scholar
Irwin, M., Patterson, T., Smith, T. L., et al., Reduction of immune function in life stress and depression. Biol. Psychiatry 27 (1990), 22–30.Google Scholar
M. Irwin, H. Weiner, Depressive symptoms and immune function during bereavement. In Biopsychosocial Aspects of Bereavement, ed. Zisook, S. (Washington, DC: APA Press, 1987), pp. 156–74.
Maes, M., Planken, M., Stevens, W. J., et al., Leukocytosis, monocytosis, and neutrophilia: hallmarks of severe depression. J. Psychiatr. Res. 26 (1992), 125–34.Google Scholar
Kronfol, Z., Turner, R., Nasrallah, H., Winokur, G., Leukocyte regulation in depression and schizophrenia. Psychiatry Res. 13 (1984), 13–18.Google Scholar
Irwin, M., Smith, T. L., Gillin, J. C., Low natural killer cytotoxicity in major depression. Life Sci. 41 (1987), 2127–33.Google Scholar
Surtees, P., Wainwright, N., Day, N., et al., Association of depression with peripheral leukocyte counts in EPIC-Norfolk-role of sex and cigarette smoking. J. Psychsom. Res. 54 (2003), 303–6.Google Scholar
Schleifer, S. J., Bartlett, J. A., Keller, S. E., et al., Immunity in adolescents with major depression. J. Am. Acad. Child Adolesc. Psychiatry 41 (2002), 1054–60.Google Scholar
Herbert, T. B., Cohen, S., Depression and immunity: a meta-analytic review. Psychol. Bull. 113 (1993), 472–86.Google Scholar
Evans, D. L., Folds, J. D., Petitto, J. M., et al., Circulating natural killer cell phenotypes in men and women with major depression. Arch. Gen. Psychiatry 49 (1992), 388–95.Google Scholar
Schleifer, S. J., Keller, S. E., Bond, R. N., Cohen, J., Stein, M., Major depressive disorder and immunity: role of age, sex, severity, and hospitalization. Arch. Gen. Psychiatry 46 (1989), 81–7.Google Scholar
Zorrilla, E. P., Luborsky, L., McKay, J. R., et al., The relationship of depression and stressors to immunological assays: a meta-analytic review. Brain Behav. Immun. 15 (2001), 199–226.Google Scholar
Kronfol, Z., House, J. D., Depression, hypothalamic-pituitary adrenocortical activity and lymphocyte function. Psychopharmacol. Bull. 21 (1985), 476–8.Google Scholar
Kronfol, Z., Silva, J., Greden, J., et al., Impaired lymphocyte function in depressive illness. Life Sci. 33 (1983), 241–7.Google Scholar
Albrecht, J., Helderman, J., Schlesser, M., Rush, J., A controlled study of cellular immune function in affective disorders before and during somatic therapy. Psychiatry Res. 15 (1985), 185–93.Google Scholar
Syvalahti, E., Eskola, J., Ruuskanen, O., Laine, T., Nonsuppression of cortisol and immune function in depression. Prog. Neuropsychopharmacol. Biol. Psychiatry 9 (1985), 413–22.Google Scholar
Schleifer, S. J., Keller, S. E., Siris, S. G., Davis, K. L., Stein, M., Depression and immunity: lymphocyte function in ambulatory depressed patients, hospitalized schizophrenic patients, and patients hospitalized for herniorrhaphy. Arch. Gen. Psychiatry 42 (1985), 129–33.Google Scholar
Kronfol, Z., House, J. D., Silva, J., Greden, J., Carroll, B. J., Depression, urinary free cortisol excretion, and lymphocyte function. Br. J. Psychiatry 148 (1986), 70–73.Google Scholar
Calabrese, J. R., Skwerer, R. G., Barna, B., et al., Depression, immunocompetence, and prostaglandins of the E-series. Psychol. Res. 17 (1986), 41–7.Google Scholar
Lowy, M. T., Reder, A. T., Gormley, G. J., Meltzer, H. Y., Comparison of in vivo and in vitro glucocorticoid sensitivity in depression: relationship to the dexamethasone suppression test. Biol. Psychiatry 24 (1988), 619–30.Google Scholar
Maes, M., Bosmans, E., Suy, E., Minner, B., Raus, J., Impaired lymphocyte stimulation by mitogens in severely depressed patients: a complex interface with HPA axis hyperfunction, noradrenergic activity and the ageing process. Br. J. Psychiatry 155 (1989), 793–8.Google Scholar
Altshuler, L. L., Plaeger-Marshall, S., Richeimer, S., Daniels, M., Baxter, L. R. Jr, Lymphocyte function in major depression. Acta Psychiatr. Scand. 80 (1989), 132–6.Google Scholar
Darko, D. F., Gillin, J. C., Risch, S. C., et al., Mitogen-stimulated lymphocyte proliferation and pituitary hormones in major depression. Biol. Psychiatry 26 (1989), 145–55.Google Scholar
Kronfol, Z., Nair, M., Goodson, J., et al., Natural killer cell activity in depressive illness: a preliminary report. Biol. Psychiatry 26 (1989), 753–6.Google Scholar
Cosyns, P., Maes, M., Vandewoude, M., et al., Impaired mitogen-induced lymphocyte responses and the hypothalamic-pituitary-adrenal axis in depressive disorders. J. Affect. Disord. 16 (1989), 41–8.Google Scholar
Bartoloni, C., Guidi, L., Antico, L., et al., Psychological status of institutionalized aged: influences on immune parameters and endocrinological correlates. Int. J. Neurosci. 51 (1990), 279–81.Google Scholar
McAdams, C., Leonard, B. E., Neutrophil and monocyte phagocytosis in depressed patients. Prog. Neuropsychopharmacol. Biol. Psychiatry 17 (1993), 971–84.Google Scholar
Birmaher, B., Rabin, B. S., Garcia, M. R., et al., Cellular immunity in depressed, conduct disorder, and normal adolescents: role of adverse life events. J. Am. Acad. Child Adolesc. Psychol. 33 (1994), 671–8.Google Scholar
Schleifer, S. J., Keller, S. E., Bartlett, J. A., Panic disorder and immunity: few effects on circulating lymphocytes, mitogen response, and NK cell activity. Brain Behav. Immun. 16 (2002), 698–705.Google Scholar
Stein, M., Miller, A. H., Trestman, R. L., Depression, the immune system, and health and illness. Arch. Gen. Psychiatry 48 (1991), 171–7.Google Scholar
Irwin, M., Miller, C., Decreased natural killer cell responses and altered interleukin-6 and interleukin-10 production in alcoholism: an interaction between alcohol dependence and African-American ethnicity. Alcohol Clin. Exp. Res. 24 (2000), 560–69.Google Scholar
Irwin, M., Effects of sleep and sleep loss on immunity and cytokines. Brain Behav. Immun. 16 (2002), 503–12.Google Scholar
Mohl, P. C., Huang, L., Bowden, C., et al., Natural killer cell activity in major depression. Am. J. Psychiatry 144 (1987), 1619.Google Scholar
Kronfol, Z., Remick, D. G., Cytokines and the brain: implications for clinical psychiatry. Am. J. Psychiatry 157 (2000), 683–94.Google Scholar
Bauer, M. E., Papadopoulos, A., Poon, L., et al., Altered glucocorticoid immunoregulation in treatment resistant depression. Psychoneuroendocrinology 28 (2003), 49–65.Google Scholar
Seidel, A., Arolt, V., Hunstiger, M., et al., Cytokine production and serum proteins in depression. Scand. J. Immunol. 41 (1995), 534–8.Google Scholar
Trzonkowski, P, Mysliwska, J., Godlewska, B., et al., Immune consequences of the spontaneous pro-inflammatory status in depressed elderly patients. Brain Behav. Immun. 18 (2004), 135–48.Google Scholar
Maes, M. A., review on the acute phase response in major depression. Rev. Neurosci. 4 (1993), 407–16.Google Scholar
Maes, M., Scharpe, S., Grootel, L., et al., Higher alpha 1-antritrypsin, haptoglobin, ceruloplasmin and lower retinol binding protein plasma levels during depression: further evidence for the existence of an inflammatory respose during that illness. J. Affect. Disord. 24 (1992), 183–92.Google Scholar
Musselman, D. L., Miller, A. H., Porter, M. R., et al., Higher than normal plasma interleukin-6 concentrations in cancer patients with depression: preliminary findings. Am. J. Psychiatry 158 (2001), 1252–7.Google Scholar
Miller, G. E., Stetler, C. A., Carney, R. M., Freedland, K. E., Banks, W. A., Clinical depression and inflammatory risk markers for coronary heart disease. Am. J. Cardiol. 90 (2002), 1279–83.Google Scholar
Pike, J. L., Irwin, M. R., Dissociation of inflammatory markers and natural killer cell activity in major depressive disorder. Brain Behav. Immun. 20 (2006), 169–74.Google Scholar
Penninx, B. W., Kritchevsky, S. B., Yaffe, K., et al., Inflammatory markers and depressed mood in older persons: results from the health, aging and body composition study. Biol. Psychiatry 54 (2003), 566–72.Google Scholar
Brambilla, F., Monteleone, P., Maj, M., Interleukin-1beta and tumor necrosis factor-alpha in children with major depressive disorder or dysthymia. J. Affect. Disord. 78 (2004), 273–7.Google Scholar
Stastny, J., Konstantinidis, A., Schwarz, M. J., et al., Effects of tryptophan depletion and catecholamine depletion on immune parameters in patients with seasonal affective disorder in remission with light therapy. Biol. Psychiatry 53 (2003), 332–7.Google Scholar
Lesperance, F., Frasure-Smith, N., Theroux, P., Irwin, M., The association between major depression and levels of soluble intercellular adhesion molecule 1, interleukin-6, and C-reactive protein in patients with recent acute coronary syndromes. Am. J. Psychiatry 161 (2004), 271–7.Google Scholar
Zautra, A. J., Yocum, D. C., Villanueva, I., et al., Immune activation and depression in women with rheumatoid arthritis. J. Rheumatol. 31 (2004) 457–63.Google Scholar
Miller, A. H., Cytokines and sickness behavior: implications for cancer care and control. Brain Behav. Immun. 17: Suppl 1 (2003), 132–4.Google Scholar
Miller, G. E., Cohen, S., Pressman, S., et al., Psychological stress and antibody response to influenza vaccination: when is the critical period for stress, and how does it get inside the body?Psychosom. Med. 66 (2004), 215–23.Google Scholar
Irwin, M., Costlow, C., Williams, H., et al., Cellular immunity to varicella-zoster virus in patients with major depression. J. Infect. Dis. 178 (1998), 104–8.Google Scholar
Dhabhar, F. S., Acute stress enhances while chronic stress suppresses skin immunity: the role of stress hormones and leukocyte trafficking. Ann. N. Y. Acad. Sci. 917 (2000), 876–93.Google Scholar
Hickie, I., Hickie, C., Lloyd, A., Silove, D., Wakefield, D., Impaired in vivo immune responses in patients with melancholia. Br. J. Psychiatry 162 (1993), 651–7.Google Scholar
Shinkawa, M., Nakayama, K., Hirai, H., Monma, M., Sasaki, H., Depression and immunoreactivity in disabled older patients. J. Am. Geriatr. Soc. 50 (2002), 198–9.Google Scholar
Glaser, R., Kiecolt-Glaser, J. K., Bonneau, R. H., et al., Stress-induced modulation of the immune response to recombinant hepatitis B vaccine. Psychosom. Med. 54 (1992), 22–9.Google Scholar
Kiecolt-Glaser, J. K., Glaser, R., Gravenstein, S., Malarkey, W. B., Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc. Natl. Acad. Sci. U. S. A. 93 (1996), 3043–7.Google Scholar
Vedhara, K., Cox, N. K., Wilcock, G. K., et al., Chronic stress in elderly carers of dementia patients and antibody response to influenza vaccination. Lancet 353 (1999), 627–31.Google Scholar
Vedhara, K., McDermott, M. P., Evans, T. G., et al., Chronic stress in nonelderly caregivers: psychological, endocrine and immune implications. J. Psychosom. Res. 53 (2002), 1153–61.Google Scholar
Rohleder, N., Schommer, N. C., Hellhammer, D. H., Engel, R., Kirschbaum, C., Sex differences in glucocorticoid sensitivity of proinflammatory cytokine production after psychosocial stress. Psychosom. Med. 63 (2001), 966–72.Google Scholar
Irwin, M., Mascovich, A., Gillin, J. C., et al., Partial sleep deprivation reduces natural killer cell activity in humans. Psychosom. Med. 56 (1994), 493–8.Google Scholar
Irwin, M., McClintick, J., Costlow, C., et al., Partial night sleep deprivation reduces natural killer and cellular immune responses in humans. FASEB J. 10 (1996), 643–53.Google Scholar
Irwin, M., Smith, T. L., Gillin, J. C., Electroencephalographic sleep and natural killer activity in depressed patients and control subjects. Psychosom. Med. 54 (1992), 107–26.Google Scholar
Cover, H., Irwin, M., Immunity and depression: insomnia, retardation, and reduction of natural killer cell activity. J. Behav. Med. 17 (1994), 217–23.Google Scholar
Castanon, N., Leonard, B. E., Neveu, P. J., Yirmiya, R., Effects of antidepressants on cytokine production and actions. Brain Behav. Immun. 16 (2002), 569–74.Google Scholar
Goujon, E., Parnet, P., Laye, S., et al., Stress downregulates lipopolysaccharide-induced expression of proinflammatory cytokines in the spleen, pituitary, and brain of mice. Brain Behav. Immun. 9 (1995), 292–303.Google Scholar
Barden, N., Regulation of corticosteroid receptor gene expression in depression and antidepressant action. J. Psychiatry Neurosci. 24 (1999), 25–39.Google Scholar
Yirmiya, R., Weidenfeld, J., Pollak, Y., et al., Cytokines, ‘depression due to a general medical condition’, and antidepressant drugs. Adv. Exp. Med. Biol. 461 (1999), 283–316.Google Scholar
Yaron, I., Shirazi, L., Judovich, R., et al., Fluoxetine and amitriptyline inhibit nitric oxide, prostaglandin E2, and hyaluronic acid production in human synovial cells and synovial tissue cultures. Arthritis Rheum. 42 (1999), 2561–8.Google Scholar
Hindmarch, F., Expanding the horizons of depression: beyond the monoamine hypothesis. Hum. Psychopharm. 16 (2001), 203–18.Google Scholar
Kubera, M., Kenis, G., Bosmans, E., et al., Stimulatory effect of antidepressants on the production of IL-6. Int. Immunopharmacol. 4 (2004), 185–92.Google Scholar
Irwin, M., Lacher, U., Caldwell, C., Depression and reduced natural killer cytotoxicity: a longitudinal study of depressed patients and control subjects. Psychol. Med. 22 (1992), 1045–50.Google Scholar
Schleifer, S. J., Keller, S. E., Bartlett, J. A., Depression and immunity: clinical factors and therapeutic course. Psychiatry Res. 85 (1999), 63–9.Google Scholar
Frank, M. G., Hendricks, S. E., Johnson, D. R., Wieseler, J. L., Burke, W. J., Antidepressants augment natural killer cell activity: in vivo and in vitro. Neuropsychobiology 39 (1999), 18–24.Google Scholar
Kim, Y., Suh, I. B., Kim, H., et al., The plasma levels of interleukin-12 in schizophrenia, major depression, and bipolar mania: effects of psychotropic drugs. Mol. Psychiatry 7 (2002), 1107–14.Google Scholar
Kenis, G., Maes, M., Effects of antidepressants on the production of cytokines. Int. J. Neuropsychopharmacol. 5 (2002), 401–12.Google Scholar
Sluzewska, A., Indicators of immune activation in depressed patients. Adv. Exp. Med. Biol. 461 (1999), 59–73.Google Scholar
Maes, M., Scharpe, S., Meltzer, H. Y., et al., Relationships between interleukin-6 activity, acute phase proteins, and function of the hypothalamic-pituitary-adrenal axis in severe depression. Psychiatry Res. 49 (1993), 11–27.Google Scholar
Maes, M., Bosmans, E., Meltze, H. Y., Scharpe, S., Suy, E., Interleukin-1 beta: a putative mediator of HPA axis hyperactivity in major depression. Am. J. Psychiatry 150 (1993), 1189–93.Google Scholar
Irwin, M., Daniels, M., Risch, S. C., Bloom, E., Weiner, H., Plasma cortisol and natural killer cell activity during bereavement. Biol. Psychiatry 24 (1988), 173–8.Google Scholar
Raison, C., Miller, A. H., When not enough is too much: the role of insufficient glucocorticoid signaling in the pathophysiology of stress-related disorders. Am. J. Psychiatry 160 (2003), 1554–65.Google Scholar
Sopori, M. L., Kozak, W., Immunomodulatory effects of cigarette smoke. J. Neuroimmunol. 83 (1998), 148–56.Google Scholar
Rosecrans, J. A., Karin, L. D., Effects of nicotine on the hypothalamic-pituitary-axis (HPA) and immune function: introduction to the Sixth Nicotine Round Table Satellite, American Society of Addiction Medicine Nicotine Dependence Meeting. Psychoneuroendocrinology 23 (1998), 95–102.Google Scholar
McAllister-Sistilli, C. G., Caggiula, A. R., Knopf, S., et al., The effects of nicotine on the immune system. Psychoneuroendocrinology 23 (1998), 175–87.Google Scholar
Jung, W., Irwin, M., Reduction of natural killer cytotoxic activity in major depression: interaction between depression and cigarette smoking. Psychosom. Med. 61 (1999), 263–70.Google Scholar
Mendall, M. A., Patel, P., Asante, M., et al., Relation of serum cytokine concentrations to cardiovascular risk factors and coronary heart disease. Heart 78 (1997), 273–7.Google Scholar
Linkins, R. W., Comstock, G. W., Depressed mood and development of cancer. Am. J. Epidemiol. 132 (1990), 962–72.Google Scholar
Schuckit, M. A., Tipp, J. E., Bergman, M., et al., Comparison of induced and independent major depressive disorders in 2945 alcoholics. Am. J. Psychiatry 54 (1997), 948–57.Google Scholar
Irwin, M., Caldwell, C., Smith, T. L., et al., Major depressive disorder, alcoholism, and reduced natural killer cell cytotoxicity: role of severity of depressive symptoms and alcohol consumption. Arch. Gen. Psychiatry 47 (1990), 713–19.Google Scholar
Irwin, M., Schuckit, M., Smith, T. L., Clinical importance of age at onset in Type 1 and Type 2 primary alcoholics. Arch. Gen. Psychiatry 47 (1990), 320–24.Google Scholar
Irwin, M., Rinetti, G., Redwine, L., Motivala, S., Ehlers, C., Pro-inflammatory cytokines and disordered sleep in alcohol dependence. Psychosom. Med. 65 (2003), A-4.Google Scholar
Hall, M., Baum, A., Buysse, D. J., et al., Sleep as a mediator of the stress-immune relationship. Psychosom. Med. 60 (1998), 48–51.Google Scholar
Irwin, M., Clark, C., Kennedy, B., Gillin, J. Christian, Ziegler, M., Nocturnal catecholamines and immune function in insomniacs, depressed patients, and control subjects. Brain Behav. Immun. 17 (2003), 365–72.Google Scholar
Savard, J., Laroche, L., Simard, S., Ivers, H., Morin, C. M., Chronic insomnia and immune functioning. Psychosom. Med. 65 (2003), 211–21.Google Scholar
Irwin, M., Gillin, J. C., Dang, J., et al., Sleep deprivation as a probe of homeostatic sleep regulation in primary alcoholics. Biol. Psychiatry 51 (2002), 632–41.Google Scholar
Irwin, M., Miller, C., Gillin, J. C., Demodena, A., Ehlers, C. L., Polysomnographic and spectral sleep EEG in primary alcoholics: an interaction between alcohol dependence and African-American ethnicity. Alcohol Clin. Exp. Res. 24 (2000), 1376–84.Google Scholar
Redwine, L., Dang, J., Hall, M., Irwin, M., Disordered sleep, nocturnal cytokines, and immunity in alcoholics. Psychosom. Med. 65 (2003), 75–85.Google Scholar
Black, P. H., Garbutt, L. D., Stress, inflammation and cardiovascular disease. J. Psychosom. Res. 52 (2002), 1–23.Google Scholar
Redwine, L., Snow, S., Mills, P., Irwin, M., Acute psychological stress: effects on chemotaxis and cellular adhesion molecule expression. Psychosom. Med. 65 (2003), 598–603.Google Scholar
Goebel, M. U., Mills, P. J., Irwin, M. R., Ziegler, M. G., Interleukin-6 and tumor necrosis factor-alpha production after acute psychological stress, exercise, and infused isoproterenol: differential effects and pathways. Psychosom. Med. 62 (2000), 591–8.Google Scholar
Sheridan, J. F., Dobbs, C., Brown, D., Zwilling, B., Psychoneuroimmunology: stress effects on pathogenesis and immunity during infection. Clin. Microbiol. Rev. 7 (1994), 200–12.Google Scholar
S. Cohen, G. Miller, Stress, immunity and susceptibility to upper respiratory infection. In Psychoneuroimmunology, 3rd edn, ed. Ader, R., Felten, D., Cohen, N. (San Diego, CA: Academic Press, 2000), pp. 499–509.
Cole, S. W., Naliboff, B. D., Kemeny, M. E., et al., Impaired response to HAART in HIV-infected individuals with high autonomic nervous system activity. Proc. Natl. Acad. Sci. U. S. A. 98 (2001), 12 695–700.Google Scholar
Cole, S. W., Kemeny, M. E., Taylor, S. E., Social identity and physical health: accelerated HIV progression in rejection-sensitive gay men. J. Pers. Soc. Psychol. 72 (1997), 320–35.Google Scholar
Cole, S. W., Korin, Y. D., Fahey, J. L., Zack, J. A., Norepinephrine accelerates HIV replication via protein kinase A-dependent effects on cytokine production. J. Immunol. 161 (1998), 610–16.Google Scholar
Sternberg, E. M., Chrousos, G. P., Wilder, R. L., Gold, P. W., The stress response and the regulation of inflammatory disease. Ann. Intern. Med. 117 (1992), 854–66.Google Scholar
Crofford, L. J., Kalogeras, K. T., Mastorakos, G., et al., Circadian relationships between interleukin (IL)-6 and hypothalamic-pituitary-adrenal axis hormones: failure of IL-6 to cause sustained hypercortisolism in patients with early untreated rheumatoid arthritis. J. Clin. Endocrinol Metab. 82 (1997), 1279–83.Google Scholar
Dickens, C., McGowan, L., Clark-Carter, D., Creed, F., Depression in rheumatoid arthritis: a systematic review of the literature with meta-analysis. Psychosom. Med. 64 (2002), 52–60.Google Scholar
Zautra, A. J., Smith, B. W., Depression and reactivity to stress in older women with rheumatoid arthritis and osteoarthritis. Psychosom. Med. 63 (2001), 687–96.Google Scholar
Smyth, J. M., Stone, A. A., Hurewitz, A., Kaell, A., Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis: a randomized trial. J. Am. Med. Assoc. 281 (1999), 1304–9.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×