Dorian B, Garfinkel P E
Psychol Med. 1987 May;17(2):393-407. doi: 10.1017/s0033291700024958.
Psychological factors have long been thought to play a contributing role in either the predisposition, onset or course of various physical illnesses. Recently, rapid advances in immunology have created interest in the interaction between psychosocial factors, behaviour and the immune system. This paper reviews some of the models proposed to explain the relationship between psychological variables and physical illness and presents evidence for a contribution of psychological factors to certain illnesses in which abnormalities in immunologic state are thought to be important. From a somewhat different perspective, animal studies have demonstrated complex effects of stress, on disease susceptibility. Recent human studies have demonstrated consistent immunologic changes in people undergoing acute naturally occurring psychological stress such as bereavement or an important examination. In humans, the effects of chronic stress may be different from acute stress, corresponding to the findings in animals. Abnormalities in immunologic functioning and physical illness are reviewed for different psychiatric disorders--depression, anorexia nervosa and schizophrenia; depression is the only disorder which consistently demonstrated immunologic changes. Possible mechanisms for the stress/immune-change relationship are suggested.
长期以来，人们一直认为心理因素在各种身体疾病的易感性、发病或病程中起一定作用。最近，免疫学的迅速发展引发了人们对心理社会因素、行为与免疫系统之间相互作用的兴趣。本文回顾了一些为解释心理变量与身体疾病之间的关系而提出的模型，并提供证据表明心理因素对某些疾病有影响，在这些疾病中，免疫状态异常被认为是重要的。从略有不同的角度来看，动物研究已经证明了压力对疾病易感性的复杂影响。最近的人体研究表明，经历自然发生的急性心理压力（如丧亲或重要考试）的人会出现一致的免疫变化。在人类中，慢性压力的影响可能与急性压力不同，这与动物研究的结果一致。本文针对不同的精神疾病——抑郁症、神经性厌食症和精神分裂症——综述了免疫功能异常和身体疾病的情况；抑郁症是唯一始终表现出免疫变化的疾病。文中还提出了压力/免疫变化关系的可能机制。
