期刊
JOURNAL OF PSYCHOSOMATIC RESEARCH
卷 58, 期 1, 页码 3-13出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychores.2004.05.010
关键词
HIV/AIDS; stress management; immune; cortisol; depression
类别
资金
- NATIONAL INSTITUTE OF MENTAL HEALTH [T32MH018917, P01MH049548] Funding Source: NIH RePORTER
- NIMH NIH HHS [P01 MH49548, T32 MH18917] Funding Source: Medline
Background: Stress management interventions reduce distress symptoms and hypothalamic pituitary-adrenal (HPA) axis hormones such as cortisol, which has been related to a down-regulation of immune system components relevant to the human immunodeficiency virus (HIV) infection. We previously showed that HIV+ men assigned to a 10-week cognitive behavioral stress management (CBSM) intervention showed more CD4+CD45RA+CD29+ lymphocytes, an indicator of immune system reconstitution, at a 6- to 12-month follow-up compared with controls. Here, we tested whether reductions in urinary cortisol output and depressed mood during the 10-week CBSM intervention period mediated its effects on this immune system reconstitution marker at follow-up. Methods: Twenty-five HIV-infected men randomized to either a 10-week CBSM intervention or a wait-list control provided 24-h urine samples and psychological responses pre- to postintervention, which were related to changes in immune status over a 6- to 12-month follow-up period. Results: Greater reductions in cortisol output and depressed mood during CBSM appeared to mediate the effects of this intervention on this indicator of immune system reconstitution over the 6- to 12-month follow-up period. Changes in mood were maintained over the follow-up period, although these did not add explanatory information beyond the cortisol and mood changes that were observed during the 10-week intervention period. These findings were not explained by the changes in medications or health behaviors during follow-up. Conclusion: A time-limited CBSM intervention may affect the rate of immune system reconstitution in HIV-infected men by modifying the stress of symptomatic disease. This intervention may work by decreasing depressed mood and normalizing HPA axis functioning. (c) 2005 Elsevier Inc. All rights reserved.
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