Dubois Thomas, Reynaert Christine, Jacques Denis, Zdanowicz Nicolas
Université Catholique de Louvain, Psychosomatics Unit, Mont-Godinne University Hospital, 5530 Yvoir, Belgium,
Psychiatr Danub. 2017 Sep;29(Suppl 3):254-258.
A large amount of evidence has already shown associations between depression and immunity, a bi-directional relationship seems to be increasingly evident. We showed in several precedent studies that family dynamics (Dubois et al. 2016, Zdanowicz et al. 2015), some coping skills (Manceaux et al. 2016) or gender (Fagniart et al. 2016) are correlated with depression and/or immunity and change the way depression and immunity interact together.
The objective of this review is to study the literature in search of older and recent evidence about how immunity and depression interact and which determinants influence this relationship. We searched on PubMed, PsycINFO, PsycARTICLES and Sciencedirect articles with the keywords immunity and depression and with coping, gender and family.
Surprisingly we observed in the literature that depression is mostly correlated with both inflammatory and impaired immunity mainly for cell-mediated immunity. Recent studies showed that gender differences in immunity seems to explain in part some variabilities concerning depression and acute/chronic stress among men and women. There is evidence for a sexual dimorphism of the immune system. Coping style, perceived control or personality impact the immune system. There is evidence that childhood maltreatment or stress occurring early in life can exert persistent effects over a long period of time like a "biological scar".
There seems to be an individual and biological heterogeneity behind the label of major depressive disorder. We demonstrated the role of several modulators on immunity and depression such as gender, coping, personality, early-life stress or relationships. Many other modulators could exist and should be considered for further investigations.
大量证据已表明抑郁症与免疫力之间存在关联,一种双向关系似乎越来越明显。我们在先前的几项研究中表明,家庭动态(杜波依斯等人,2016年;兹达诺维茨等人,2015年)、一些应对技巧(曼索等人,2016年)或性别(法尼亚特等人,2016年)与抑郁症和/或免疫力相关,并改变了抑郁症和免疫力相互作用的方式。
本综述的目的是研究文献,以寻找关于免疫力和抑郁症如何相互作用以及哪些决定因素影响这种关系的新旧证据。我们在PubMed、PsycINFO、PsycARTICLES和ScienceDirect上搜索了关键词为免疫力和抑郁症以及应对、性别和家庭的文章。
令人惊讶的是,我们在文献中观察到,抑郁症主要与炎症和免疫功能受损相关,主要是针对细胞介导的免疫。最近的研究表明,免疫力的性别差异似乎部分解释了男性和女性在抑郁症和急性/慢性应激方面的一些变异性。有证据表明免疫系统存在性二态性。应对方式、感知到的控制或个性会影响免疫系统。有证据表明,童年期虐待或生命早期发生的应激会在很长一段时间内产生持续影响,就像一个“生物疤痕”。
在重度抑郁症这一标签背后似乎存在个体和生物学异质性。我们证明了几种调节因素对免疫力和抑郁症的作用,如性别、应对方式、个性、生命早期应激或人际关系。可能还存在许多其他调节因素,应考虑进一步研究。