Seiler Annina, von Känel Roland, Slavich George M
Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States.
Front Psychiatry. 2020 Dec 3;11:565239. doi: 10.3389/fpsyt.2020.565239. eCollection 2020.
Losing a spouse is considered one of the most stressful life events a person can experience. Particularly in the immediate weeks and months after the loss, bereavement is associated with a significantly increased risk of morbidity and mortality. Despite an abundance of research aimed at identifying risk factors for adverse health outcomes following marital death, the mechanisms through which mental and physical health problems emerge following bereavement remain poorly understood. To address this issue, the present review examines several pathways that may link bereavement and health, including inflammation and immune dysregulation, genetic and epigenetic changes, gut microbiota activity, and biological aging. We then describe how these processes may be viewed from the perspective of the Social Signal Transduction Theory of Depression to provide a novel framework for understanding individual differences in long-term trajectories of adjustment to interpersonal loss. Finally, we discuss several avenues for future research on psychobiological mechanisms linking bereavement with mental and physical health outcomes.
失去配偶被认为是一个人可能经历的最具压力的生活事件之一。特别是在失去配偶后的几周和几个月内,丧亲之痛与发病率和死亡率显著增加有关。尽管有大量研究旨在确定婚姻死亡后不良健康结果的风险因素,但丧亲后心理健康问题和身体健康问题出现的机制仍知之甚少。为了解决这个问题,本综述探讨了几种可能将丧亲之痛与健康联系起来的途径,包括炎症和免疫失调、遗传和表观遗传变化、肠道微生物群活动以及生物衰老。然后,我们描述了如何从抑郁症的社会信号转导理论的角度看待这些过程,以提供一个新的框架来理解个体在人际丧失长期适应轨迹上的差异。最后,我们讨论了未来关于将丧亲之痛与心理健康和身体健康结果联系起来的心理生物学机制的几个研究途径。