Mulder C L, Antoni M H, Emmelkamp P M, Veugelers P J, Sandfort T G, van de Vijver F A, de Vries M J
Helen Dowling Institute for Biopsychosocial Medicine, Rotterdam, The Netherlands.
Psychother Psychosom. 1995;63(3-4):185-92. doi: 10.1159/000288958.
The aim of the study was to determine changes in the rate of decline of immunological parameters after psychosocial group intervention. Subjects were 26 asymptomatic HIV-infected homosexual men who participated in a cognitive-behavioral group therapy (CBT; n = 14), or an experiential group therapy program (ET; n = 12), both of 15 weeks duration. The outcome measures were changes in the decline of CD4 cell counts, and T cell proliferative responses to anti-CD3 monoclonal antibodies from preintervention to 24 months postintervention. No differences in the rate of decline of CD4 cells or T cell responses between the CBT and ET condition were found, and there were no significant changes in CD4 cell count from pre- to postintervention. However, those subjects who showed larger decreases in distress showed a smaller decline in CD4 cell counts. While the rate of decline in T cell responses was significantly less after both interventions, a similar positive change in T cell responses was found in a comparison group of 149 HIV-infected men with similar demographic, psychosocial and immunological characteristics who did not participate in one of the interventions. We conclude that the psychosocial intervention programs tested here did not cause changes in CD4 cell decline or T cell responses and that decreases in distress were related to increases in CD4 cell counts.
本研究的目的是确定心理社会群体干预后免疫参数下降速率的变化。研究对象为26名无症状的HIV感染同性恋男性，他们参加了为期15周的认知行为团体治疗（CBT；n = 14）或体验式团体治疗项目（ET；n = 12）。结果指标为从干预前到干预后24个月CD4细胞计数的下降变化，以及T细胞对抗CD3单克隆抗体的增殖反应。未发现CBT组和ET组在CD4细胞下降速率或T细胞反应方面存在差异，且干预前后CD4细胞计数无显著变化。然而，那些痛苦程度下降较大的受试者CD4细胞计数下降幅度较小。虽然两种干预后T细胞反应的下降速率均显著降低，但在一个由149名具有相似人口统计学、心理社会和免疫学特征但未参与其中一项干预的HIV感染男性组成的对照组中，也发现了类似的T细胞反应阳性变化。我们得出结论，此处测试的心理社会干预项目并未导致CD4细胞下降或T细胞反应发生变化，且痛苦程度的降低与CD4细胞计数的增加有关。
