Self-rated health is a powerful predictor of long-term health, but relatively little is known about what determines an individual’s rating of her perceived health status. Psychoneuroimmunological research has found links between immune activity and behaviour, and a relation between low-grade inflammation and poor self-rated health, primarily in women. The principal aim of this paper was to examine the relation between self-rated health and inflammation, measured by erythrocyte sedimentation rate (ESR), in young men. A secondary objective was to investigate whether self-rated health and ESR may be associated to mortality. Pearson correlation and Cox regression analyses were used to examine data collected in 1969-70 when 49,321 men underwent military conscription, together with information from the national cause of death register in 2006. Background factors (BMI, emotional control, psychiatric diagnosis and smoking) were included in multivariate analyses. The results show that self-rated health was significantly related to ESR (r=0.08, p<0.001), also after control for background factors. Furthermore, subjects with poor self-rated health had a near two-fold increased risk of mortality during 37 years of follow-up. In addition, ESR was a significant predictor of mortality (beta=0.051, p<0.002). To conclude, in this cohort of young, healthy men, the association between self-rated health and inflammation was significant but modest. Instead, low emotional control showed a stronger independent correlation to poor self-rated health (r=-0.284, p<0.001). Moreover, adding to a growing body of evidence, poor self-rated health was a strong predictor of mortality.

A comunicação entre sistema nervoso e imune contribui para a homeostasia. Em humanos, a convivência com portadores de doenças crônicas (\"caregiving\") é agente causador de alterações inclusive imunológicas. Modelos animais podem contribuir para a compreensão dos mecanismos aí envolvidos. Avaliamos aqui, em fêmeas sadias, as alterações decorrentes do convívio com parceira singenêica (C57/Bl6) portadora do melanoma B16F10. Os resultados mostraram que esta convivência, por 20 dias: 1) alterou o comportamento, sem modificar a concentração sérica de corticosterona; 2) aumentou a expressão de CD80 nas populações MHCII+CD11c+, no baço, mas não nos linfonodos; 3) diminuiu o percentual de células MHCII+CD80+ após cultura de medula óssea, por sete dias em meio com GM-CSF, IL-4 e LPS; 4) inibiu, parcialmente, a indução de uma reação de hipersensibilidade tardia; 5) não modificou o estabelecimento do melanoma. Assim, este modelo pode, com cautela, ser usado para o estudo das alterações imunes observadas em \"caregivers\". / The communication between the nervous and immune systems contributes to the homeostasis. In humans, living with chronic disease bearers (caregiving) is the causing agent of alterations including the immunological ones. Animal models can contribute for understanding the involved mechanisms. Herein, we evaluated, in healthy females, the alterations caused by cohabiting with a syngeneic (C57Bl/6) partner bearing the B16F10 melanoma. The results showed that such cohabitation for 20 days: 1) altered the behavior without modifying the corticosterone seric level; 2) increased the CD80 expression on MHC+CD11c+ cells at the spleen, but not those at the lymph node; 3) decreased the percentage of MHCII+CD80+ bone marrow cells cultured for 7 days in a GM-CSF, IL-4 and LPS medium. 4) partially inhibited the induction of a delayed type hypersensitivity; 5) did not modified the melanoma establishment. So forth, this model may cautiously be taken as a means for the study of immune alteration observed in caregivers.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-05-25T11:52:26Z No. of bitstreams: 1 caiomendesdefreitas.pdf: 4475109 bytes, checksum: b27bb514b29c024ad61c1114d0539e66 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-06-14T11:52:39Z (GMT) No. of bitstreams: 1 caiomendesdefreitas.pdf: 4475109 bytes, checksum: b27bb514b29c024ad61c1114d0539e66 (MD5) / Made available in DSpace on 2018-06-14T11:52:39Z (GMT). No. of bitstreams: 1 caiomendesdefreitas.pdf: 4475109 bytes, checksum: b27bb514b29c024ad61c1114d0539e66 (MD5) Previous issue date: 2018-02-28 / A presente pesquisa insere-se na perspectiva da psiconeuroimunologia e tem por objetivo investigar a sintomatologia depressiva, sua possível associação ao estresse psicológico e a marcadores endócrinos e imunológicos em pacientes portadores de Diabetes Mellitus Tipo 2 (DM2) acompanhados em um centro especializado de condições crônicas em Juiz de Fora (MG). Participaram do estudo 92 pacientes com DM2, divididos nos seguintes grupos: sem depressão (n=58), depressão leve (n=12), depressão moderada (n=8) e depressão grave (n=13). Foram utilizados o Inventário de Depressão de Beck (BDI-II) como medida de depressão, a Escala de Estresse Percebido (PPS-10) para medir o estresse, a escala SF-6D para avaliação do estado de saúde, sobre religiosidade/espiritualidade (R/E) a Medida Multidimensional Breve de Religiosidade/Espiritualidade (BMMRS-P) e outra sobre a felicidade subjetiva (Brazilian Version of The Sujective Happiness Scale). Foram investigadas as diferenças entre os grupos quanto ao estresse, R/E, felicidade, estado de saúde, variáveis bioquímicas (HbA1c e o nível da glicemia em jejum) e imunológicas (leucócitos, neutrófilos, linfócitos, monócitos). O tratamento estatístico foi realizado utilizando-se o teste qui-quadrado (x²) de Pearson para as variáveis categóricas e a análise de variância (ANOVA) e o teste de kruskal-wallis para as variáveis numéricas, seguidos de pos hoc tests (Bonferroni e Mann-Whitney, respectivamente). Obteve-se relações significativas (x²) entre o sexo (feminino) e depressão grave (p=0,021), assim como entre a dimensão fé religiosa/espiritual e gravidade do nível de depressão (p=0,001). Observou-se também uma associação significativa entre estresse percebido e depressão (p=0.000; F=35,212), assim como com estado de saúde (p=0.000; F=20,333) e o suporte religioso (p=0.013; F=3,823), bem como associações significativas entre experiências espirituais religiosas e níveis de depressão (p=0,001; H=17,352), superação religiosa/espiritual (p=0,049; H=7,847), auto-avaliação global religiosa/espiritual (p=0,001; H=13,431), e felicidade subjetiva (p=0,000; H=20,514). Os resultados do estudo podem auxiliar na elaboração de estratégias de promoção, prevenção e intervenção com foco na saúde mental de pacientes com DM, tais como psicoterapia, técnicas de relaxamento (meditação e yoga), assim como educação em diabetes, criando condições propícias para a evolução favorável da doença, tendo como conseqüência a melhoria geral na qualidade de vida destas pessoas. / The aim of the study was to investigate the depressive symptomatology associated to psychological stress in patients with Type 2 Diabetes Mellitus (DM2) in a specialized center of chronic conditions of Juiz de Fora – MG, in a psychoneuroimmunology framework. 92 patients with DM2, divided into four groups, took part in the study: no depression (n=58), mild depression (n=12), moderate depression (n=8) and severe depression (13). Depression [(Beck Depression Inventory (BDI-II)], stress (Perceived Stress scale (PPS-10)], health condition (SF-6D), religiousness/spirituality (R/E) (Brief Multidimensional Measurement of religiousness/Spirituality - BMMRS-P) and the subjective happiness (Brazilian Version of The Sujective Happiness Scale) were measured. The Pearson Qui-square test was used for categorical variables; analysis of variance (ANOVA) and kruskal-wallis test were used for numeric variables all at a significant p < 0.05, as well as pos hoc tests (Bonferroni and Mann-Whitny, respectively). A significant relationship (x²) between feminine gender and severe depression (p=0,021) was found, as well faith and levels of depression (p=0,001). Was also observed a significant relationship between perceived psychological stress and levels of depression (p=0.000; F=35,212), as well as health status (p=0.00; F=20,333) and religious support (p=0.013; F=3,823). In the Kruskal-Wallis test, there was a significant relationship between religious spiritual experiences and levels of depression (p=0,001; H=17,352), as well overcoming (religious / spiritual) (p=0,049; H=17,352), global self-assessment (religious / spiritual) (p=0,001; H=13,431) and subjective happiness (p=0.000; H=20,514). It is intended to use the data to elaborate strategies to promote and prevent, as well as to develop mental health interventions with diabetic patients and/or patients with other metabolic diseases aiming to create conditions for the favourable evolution of the disease, and a general improvement in the quality of life of these patients. Psychotherapy, relaxation techniques (such as meditation and yoga) as well as diabetes education may be relevant tools for more favorable prognoses in the evolution of the condition in question.

Orientadores: Joel Sales Giglio, Carmen Silvia Passos Lima / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T18:47:18Z (GMT). No. of bitstreams: 1 Paiva_SuzanadeAlbuquerque_D.pdf: 29245238 bytes, checksum: 7e6976fca7d225cc024f381a5a543af5 (MD5) Previous issue date: 2014 / Resumo: Este estudo tem como tema central o indivíduo hipermoderno, suas formas de reagir e atuar no mundo contemporâneo e os determinantes psicossociais envolvidos no adoecimento. Enfatiza características e demandas da hipermodernidade e seus efeitos na saúde dos indivíduos. Desvela eventos de vida considerados traumáticos que, de acordo com as pacientes entrevistadas, contribuíram para o adoecimento. Analisa traços de personalidade, de acordo com a teoria dos arquétipos, e os significados atribuídos pelas pacientes às suas patologias: Infarto Agudo do Miocárdio (IAM) e Câncer de Mama (CM). A pesquisa foi realizada em dois hospitais privados do Brasil. Fundamenta-se na metodologia clínico-qualitativa, tendo como recursos metodológicos a entrevista semidirigida e o procedimento desenhos-estórias, aplicados durante o período de hospitalização e logo após a alta hospitalar (15 a 30 dias). As entrevistas foram tratadas com base na análise de conteúdo, e o procedimento desenhos-estórias, à luz da Psicologia Analítica. Sete pacientes do sexo feminino são os sujeitos da pesquisa, segundo critério de saturação teórica: duas com IAM, uma com a síndrome de Takotsubo, causa rara de choque cardiogênico devido a um aneurisma agudo do ventrículo esquerdo, na ausência de coronariopatia; três com CM e uma com ambas as patologias. Por meio da análise das entrevistas e dos símbolos presentes nos desenhos, observaram-se demandas da sociedade hipermoderna por hiperformance e hiperfeição, ligadas ao adoecimento, quando em excesso. Na trajetória simbólica de vida expressa por meio dos desenhos, identificaram-se os três tipos de pensamento presentes na estrutura da psiqué, fundamentais para o equilíbrio psíquico: racional, simbólico e mitológico. As imagens consteladas nas trajetórias de vida e morte, contidas na sequência dos cinco desenhos de cada paciente, possibilitaram a realização de uma investigação clínica da personalidade mediante uma análise mais profunda das expressões arquetípicas do feminino, com base na Mitologia Grega. Os arquétipos surgem enquanto estruturas fundamentais do imaginário dos indivíduos, como forma simbólica de expressão do inconsciente coletivo. Destacam-se imagens arquetípicas do herói, da grande mãe, do self, do amor (Eros) e dos conceitos religiosos. O motivo da casa, presente nos desenhos de todas as pacientes desta pesquisa, mostrou sua importância como representação simbólica do corpo, como relação com o tempo através das memórias de vida e como ponto de referência no pós-operatório para um caminho futuro ao longo da vida. Eventos de vida traumáticos, como separações dolorosas, estresse laboral e amoroso, morte de pessoas queridas com luto não elaborado, foram observados. Tais situações podem fragilizar e, consequentemente, reduzir a habilidade de reação do sistema imunológico, causando adoecimento. Concluímos que o infarto e o câncer de mama afetam as mulheres profundamente; que compreender os significados atribuídos às doenças contribui para o equilíbrio mental e a expansão da consciência; e que os conhecimentos adquiridos poderão ser cruciais para a prevenção, tanto primária quanto secundária. O estudo tem caráter inédito pelo uso de expressões gráficas, e sugere que o trabalho de acompanhamento psicoterapêutico no hospital sustenta e promove transformações pessoais, necessárias para que pacientes possam suportar o adoecimento e alcançar experiências de vida mais significativas e saudáveis. Palavras-chave: Pesquisa Qualitativa, Hipermodernidade, Infarto Agudo do Miocárdio (IAM), Câncer de Mama (CM), Síndrome de Takotsubo, Psiconeuroendocrinoimunologia, Eventos de vida, Sentidos e significados, Expressões do Feminino, Arquétipos / Abstract: This study highlights the hypermodern individual, the ways he reacts and lives in the contemporary world and the psychosocial determinants involved in illness. It focuses on the characteristics and demands of hypermodernity and their effects on the individual¿s health. It aims to reveal life events that were experienced as traumatic and that, according to the patients interviewed, contributed to their illness. It analyses the personality traits according to the theory of the archetypes and the meanings given by the patients to their illnesses: Acute Myocardial Infarction (AMI) and Breast Cancer (BC). The research was carried out at two private hospitals in Brazil. The study is based on the Clinical Qualitative Method, through semi-directed interview and the Drawings-Stories Procedure, in an intentional sample, closed by saturation, during the period of hospitalization and immediately after being discharged from hospital (15 to 30 days). The interviews were studied based on content analysis and the drawings-stories in the light of Analytical Psychology. The subjects were seven female patients: two with Acute Myocardial Infarction (AMI), one with Takotsubo syndrome, a rare cause of cardiogenic shock due to an acute left ventricular aneurysm in the absence of coronariopathy, three with Breast Cancer (BC) and one with both pathologies. Through the analysis of the interviews and the symbols present in the drawings, we observed modern society¿s demands for hyperformance and hyperfection, which when excessive are linked to illness. Through the symbolic trajectory of life and death expressed in the drawings, we observed the three types of thought in the structure of the psyche forming the basis for mental equilibrium: rational, symbolic and mythological. The images clustered in the life and death trajectories, present in the sequence of the five drawings of each patient, permitted the clinical investigation of the personality, through a deeper analysis of the archetypal expressions of the feminine, based on Greek Mythology. The archetypes arise as archaic, important figures of the individual¿s imagery, as a symbolic expression of the collective unconscious. The most important images are the archetype of the hero, the great mother, the self, love (Eros) and religious concepts. The motif of the house, present in the drawings of all patients in this research, showed its importance as a symbolic representation of the body, as a relation to time through life¿s memories and as a post-surgical starting point of reference in the path ahead. Traumatic life events, as painful separations, work and love related stress, death of dear ones, with unresolved grief, may cause fragility and lower the immune system¿s ability to react, causing damage to health. In conclusion, infarction and breast cancer deeply affect women¿s lives; that understanding the meanings given to illness can contribute to mental stability and to the expansion of consciousness. Such knowledge may be crucial for both primary and secondary prevention. The study is unique in its use of graphic expressions, and suggests that psychotherapeutic work at the hospital may contribute to positive self-transformation, indispensable for the patients to cope with their illness and to achieve meaningful and healthier life experiences. Keywords: Qualitative Research, Hypermodernity, Acute Myocardial Infarction (AMI), Breast Cancer (BC), Takotsubo Syndrome, Psychoneuroendocrinoimmunology, Life events, Senses and Meanings, Feminine Expressions, Archetypes / Doutorado / Ciencias Biomedicas / Doutora em Ciências Médicas

Please read the abstract in the section 00front of this document / Thesis (DPhil (Psychiatry))--University of Pretoria, 2003. / Psychiatry / unrestricted

Psychoneuroimmunology is an interdisciplinary area that examines the interaction between behavior, the central nervous system, and the immune system. Many investigations have utilized a taste aversion paradigm to examine the effects of classical conditioning on an immune response. The procedure generally consists of an animal ingesting a novel flavor, and then being made ill and immunosuppressed by injection of a pharmacological agent. The animal is provided access to that flavor at a later time. The rejection of the novel flavor on the test day is called taste aversion and the depressed antibody titer has been labeled conditioned immunosuppression. The present research was designed condition a secondary immune response and expand the evaluation of such conditioning to include both antibody titer and affinity. The Enzyme Linked Immunoassay was also introduced as the procedure of choice to quantify immune reactivity. A depression in antibody titer and affinity was found following exposure to three of four test trials. Taste aversion did not correlate with the immune response as increased consumption of the novel flavor was exhibited on the third and fourth test trial. In the second experiment, the dosage of cyclophosphamide was increased. A depression in antibody affinity was found after the third and fourth test trials, which was consistent with the results of the first experiment. Unlike the first experiment, a depression in antibody titer was not attained on test days. Although taste aversion was observed in the treatment group on three of the four test trials, it had extinguished by test four. The results support the concept of conditioned suppression of an antigen specific immune response by exposure to the taste aversion paradigm. An important contribution of the present research was the use and modification of a precise and sensitive assay for quantification of titer and affinity; the demonstration of conditioned suppression in both antibody titer and affinity; and the demonstration of conditioned immunosuppression with a single component CS.

No description available.

Research in Logotherapy substantiates the influence of meaning on psychological health and Psychoneuroimmunology (PNI) corroborates the effects of psychological health on physical health. This dissertation explores the relationship between meaning and physical health hypothesising that purpose affects physical health. Methodology Exploratory factor analysis (EFA), ANOVAs and stepwise regression were used to explore three possible models. Results EFA revealed four factors, purpose, fear, vitality and aggression. Significant correlations were found between purpose, vitality (0.42) and work application (0.53). Despite the significant relationship between purpose and vitality, the lack of Chi-square is significant, suggesting that additional variables should be introduced into the model. Conclusion People reporting high levels of purpose together with low levels of fear and aggression, can be characterised by high vitality and an absence of medical conditions. Future research should focus on evaluating meaning centred interventions on immunity and vitality. / Psychology / M.A. (Psychology)

Die Psychoneuroimmunologie beschäftigt sich unter anderem mit der Frage, ob und unter welchen Bedingungen psychosozialer Stress krank macht. Humanstudien, die dieser Frage nachgehen, können dabei meist nur korrelative Zusammenhänge aufdecken. Um trotzdem Aussagen zu Mechanismen, Ursache-Wirkungsbeziehungen und klinische Relevanz treffen zu können, muss z.B. auf Befunde aus der Tierforschung oder aus in vitro-Studien zurückgegriffen werden. Ziel der vorliegenden Arbeit war es, eine Methode zu finden, welche eine breitere Interpretationsgrundlage für korrelative Befunde aus Humanstudien liefert. Als besonders viel versprechend kann die Untersuchung von Patienten mit Morbus Addison angesehen werden. Patienten mit dieser Erkrankung können aufgrund zerstörter Nebennierenrinden kein Cortisol produzieren. Dieses Fehlen von Cortisol wird medikamentös ausgeglichen. Da bislang keine experimentellen Daten zu den aus der Substitutionstherapie resultierenden freien Cortisolkonzentrationen sowie den endokrinologischen Reaktionen auf Stress vorliegen, wurden in einem ersten Schritt diese beiden Fragestellungen bearbeitet. Anschließend wurde die Methode auf immunologische Fragestellungen angewandt. Die Ergebnisse der durchgeführten Studien zeigen zum einen, dass die medikamentöse Morbus Addison-Therapie in der momentanen Form nicht geeignet ist, den bei Gesunden zu beobachtenden zirkadianen Cortisolrhythmus optimal nachzustellen. Des weiteren bestätigte sich, dass psychosozialer Stress bei Patienten mit Morbus Addison lediglich eine Noradrenalinantwort auslöst, stress-induzierte Anstiege in Cortisol und Adrenalin jedoch ausbleiben. Eine Injektion von 0.03mg/kg Hydrocortison nach einem akuten Stresstest zeigte sich als geeignet, normale stressinduzierte Cortisolanstiege und Maximalwerte nachzustellen. In den untersuchten Immunparametern unterschieden sich gesunde Probanden und Patienten mit Morbus Addison vor Stressinduktion nicht. Stress-bedingte Veränderungen in peripheren Lymphozytenzahlen lassen sich dahingehend interpretieren, dass bei Patienten zwar akut eine Einwanderung von Lymphozyten aus dem Gewebe in das Blut stattfindet, aber Cortisol mitverantwortlich ist für die anschließende Redistribution. Bleibt eine Cortisolstressantwort aus, deutet dieser Befund auf ein erhöhtes Infektionsrisiko hin. Die Verläufe zur stimulierten Produktion des Entzündungsmediators Interleukin-6 stehen im Einklang mit der Hypothese, dass stress-induzierte Cortisolkonzentrationen vor einer überschießenden Entzündungsreaktion schützen. Des weiteren lässt sich bei gesunden Probanden das Absinken der NF-?B-Aktivität nach Stress durch Cortisolwerte direkt nach Stress, bei Morbus Addison-Patienten hingegen durch Veränderungen im Noradrenalin vorhersagen. Das vorliegende Dissertationsprojekt konnte zeigen, dass die Untersuchung von Patienten mit Morbus Addison ein Erfolg versprechender Ansatz ist, um die Gültigkeit von psychoneuroimmunologischen in vitro- und Tierbefunden im intakten menschlichen Organismus zu überprüfen. Die vorliegenden Daten deuten zudem auf eine erstaunliche Anpassungsfähigkeit des Immunsystems hin, was die Notwendigkeit deutlich macht, komplexe psychoneuroimmunologische Prozesse auch im Humanbereich unter Anwendung der Kriterien Hormonsubtraktion und -substitution zu untersuchen. Die Untersuchung von Morbus Addison-Patienten wird in zukünftigen Studien sicherlich entscheidende Hinweise zur klinischen Relevanz einer normalen endokrinen Stressantwort liefern können. / The field of psychoneuroimmunology is among other things dedicated to the question, whether and on what terms psychosocial stress results in disease. Human studies investigating this question often only reveal associations. Consequences regarding mechanisms, causes, and clinical relevance, are thus usually deduced from animal or in vitro studies. The aim of the present thesis was to find an approach, which provides a broader basis for interpretations of correlative findings from human studies. The investigation of patients with Addison´s disease was regarded as the most promising approach. Due to destroyed adrenal glands, these patients are not able to produce cortisol, which therefore has to be substituted. Since no experimental data regarding free cortisol levels resulting from substitution therapy as well as endocrine stress responses are available, in a first step these two question formulations were investigated. Subsequently, this approach was used to investigate two immunological question formulations. The present studies found patients with Addison´s disease to be over-treated. Psychosocial stress resulted in noradrenaline but not in cortisol or adrenaline responses. An injection of 0.03mg/kg hydrocortisone after stress was suitable to induce increases in cortisol levels and cortisol maximums comparable to healthy subjects. Healthy subjects and patients with Addison´s disease did not differ in any baseline immune measures. Stress-induced changes in lymphocyte numbers suggest cortisol being necessary for lymphocyte redistribution subsequent to stress-induced migration into peripheral blood. Without stress-induced cortisol increases, patients are at higher risk for infectious diseases. The trajectories of stimulated interleukin-6 production support the hypothesis of stress-induced cortisol levels protecting the organism against an over-reacting inflammatory immune reaction. Furthermore, in healthy subjects post-stress cortisol levels predicted stress-induced decreases in NF-´B activity, whereas in patients with Addison´s disease noradrenaline predicted such changes. The results of the present thesis supports the assumption of Addison´s disease being a promising approach to test the validity of psychoneuroimmunological in vitro and animal data in human whole organism. Additionally, the present data emphasize the astonishing adaptability of the immune system. This further emphasizes the necessity to investigate psychoneuroimmunological processes utilizing the criteria of hormone subtraction and hormone substitution also in human research. In future studies investigation of patients with Addison´s diseases will certainly provide crucial evidence regarding the clinical relevance of a normal endocrine stress response.

Research in Logotherapy substantiates the influence of meaning on psychological health and Psychoneuroimmunology (PNI) corroborates the effects of psychological health on physical health. This dissertation explores the relationship between meaning and physical health hypothesising that purpose affects physical health. Methodology Exploratory factor analysis (EFA), ANOVAs and stepwise regression were used to explore three possible models. Results EFA revealed four factors, purpose, fear, vitality and aggression. Significant correlations were found between purpose, vitality (0.42) and work application (0.53). Despite the significant relationship between purpose and vitality, the lack of Chi-square is significant, suggesting that additional variables should be introduced into the model. Conclusion People reporting high levels of purpose together with low levels of fear and aggression, can be characterised by high vitality and an absence of medical conditions. Future research should focus on evaluating meaning centred interventions on immunity and vitality. / Psychology / M.A. (Psychology)