Salleh Mohd Razali
Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
Malays J Med Sci. 2008 Oct;15(4):9-18.
The relationship between stress and illness is complex. The susceptibility to stress varies from person to person. Among the factors that influenced the susceptibility to stress are genetic vulnerability, coping style, type of personality and social support. Not all stress has negative effect. Studies have shown that short-term stress boosted the immune system, but chronic stress has a significant effect on the immune system that ultimately manifest an illness. It raises catecholamine and suppressor T cells levels, which suppress the immune system. This suppression, in turn raises the risk of viral infection. Stress also leads to the release of histamine, which can trigger severe broncho-constriction in asthmatics. Stress increases the risk for diabetes mellitus, especially in overweight individuals, since psychological stress alters insulin needs. Stress also alters the acid concentration in the stomach, which can lead to peptic ulcers, stress ulcers or ulcerative colitis. Chronic stress can also lead to plaque buildup in the arteries (atherosclerosis), especially if combined with a high-fat diet and sedentary living. The correlation between stressful life events and psychiatric illness is stronger than the correlation with medical or physical illness. The relationship of stress with psychiatric illness is strongest in neuroses, which is followed by depression and schizophrenia. There is no scientific evidence of a direct cause-and-effect relationship between the immune system changes and the development of cancer. However, recent studies found a link between stress, tumour development and suppression of natural killer (NK) cells, which is actively involved in preventing metastasis and destroying small metastases.
压力与疾病之间的关系很复杂。人们对压力的易感性因人而异。影响压力易感性的因素包括遗传易感性、应对方式、性格类型和社会支持。并非所有压力都有负面影响。研究表明,短期压力会增强免疫系统,但慢性压力会对免疫系统产生重大影响,最终导致疾病。它会提高儿茶酚胺和抑制性T细胞水平,从而抑制免疫系统。这种抑制反过来又会增加病毒感染的风险。压力还会导致组胺释放,这可能会引发哮喘患者严重的支气管收缩。压力会增加患糖尿病的风险,尤其是超重个体,因为心理压力会改变胰岛素需求。压力还会改变胃内的酸浓度,从而导致消化性溃疡、应激性溃疡或溃疡性结肠炎。慢性压力还会导致动脉粥样硬化斑块形成,尤其是与高脂肪饮食和久坐不动的生活方式相结合时。生活压力事件与精神疾病之间的相关性比与医学或身体疾病的相关性更强。压力与精神疾病的关系在神经症中最为明显,其次是抑郁症和精神分裂症。没有科学证据表明免疫系统变化与癌症发展之间存在直接的因果关系。然而,最近的研究发现压力、肿瘤发展与自然杀伤(NK)细胞抑制之间存在联系,NK细胞在预防转移和破坏小转移灶方面发挥着积极作用。