Psychological stress and disease. JAMA, 298, 1685-1687

Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 11/2007; 298(14):1685-7. DOI: 10.1001/jama.298.14.1685
Source: PubMed


Despite widespread public belief that psychological stress leads to disease, the biomedical community remains skeptical of this conclusion. In this Commentary, we discuss the plausibility of the belief that stress contributes to a variety of disease processes and summarize the role of stress in 4 major diseases: clinical depression, cardiovascular disease (CVD), human immunodeficiency virus (HIV)/AIDS, and cancer.Corresponding Author: Sheldon Cohen, PhD, Department of Psychology, Carnegie Mellon University, 5000 Forbes Ave, Pittsburgh, PA 15213 ( Disclosures: Dr Cohen reported consulting for Johnson & Johnson Consumer Companies Inc on issues of stress measurement. None of the other authors reported any financial disclosures.Role of the Sponsor: This article is based on a paper commissioned by the Institute of Medicine Committee on Psychosocial Services to Cancer Patients and Families in Community Settings. The Institute of Medicine suggested the topic but played no role in structuring the paper; in the collection, management, and interpretation of the data; or the preparation, review, or approval of the manuscript.Additional Contributions: We thank David Krantz, PhD (Uniformed Services University of the Health Sciences), Margaret Kemeny, PhD (School of Medicine, University of California at San Francisco), Stephen Manuck, PhD, and Karen Matthews, PhD (University of Pittsburgh), and Scott Monroe, PhD (Notre Dame University), for their comments on an earlier draft; the John D. and Catherine T. MacArthur Foundation Network on Socioeconomic Status and Health and members of the Pittsburgh Mind-Body Center (HL65111, HL65112) for their intellectual support; and Ellen Conser, MA, Ashleigh Molz, and Wesley Barnhart, BS (Carnegie Mellon University), for assistance in preparing the manuscript. None of these individuals received any extra compensation for their contributions.

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    • "Psychosocial stress occurs when the individual recognises that environmental demands strain or exceed their adaptive capability. Chronic psychosocial stress in particular seems to influence the course of diseases, including cardiovascular disease, upper respiratory infections, autoimmune diseases, diabetes and depression[61]. This is in line with our findings of an association of increased psychosocial stress levels and mortality in severe COPD. "
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    ABSTRACT: Background: Chronic obstructive pulmonary disease (COPD) impairs physical status and impacts on mental health. This prospective study was designed to assess associations between mental health and systemic biomarkers, and their combined relationship with long-term survival in stable severe COPD. Methods: Forty-five patients with severe but stable COPD (forced expiratory volume in 1 s of 29.8 (quartiles: 22.6; 41.4) %predicted) were assessed using the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire (PHQ), St. George's Respiratory Questionnaire and the State-Trait Anxiety Inventory (STAI). The following serum biomarkers were measured: 25-OH-cholecalciferol, C-reactive protein, erythrocyte sedimentation rate, leucocyte number, serum amyloid-A (SA-A), N-terminal pro-brain natriuretic peptide, troponin I, glycosylated haemoglobin, haemoglobin (Hb), haematocrit (Hc), creatinine and thyroid-stimulating hormone. Patients were followed-up for 36 months. Associations between aspects of mental health and biomarkers, and their utility as predictors of 3-year survival were evaluated by regression analyses. Results: The prevalence of anxiety (HADS-A: 89.9 %), depression (HADS-D: 58.8 %; PHQ: 60.6 %), somatisation (PHQ-15: 81.8 %) and psychosocial stress (PHQ-stress: 60.6 %) was high. There was a significant positive association between the leucocyte count and SA-A level with STAI-trait anxiety (p = 0.03 and p = 0.005, respectively), and between leucocytes and PHQ-stress (p = 0.043). Hb and Hc were significantly negatively associated with HADS-depression (p = 0.041 and p = 0.031, respectively). Univariate Cox regression analyses revealed that leucocyte count (hazard ratio (HR) 2.976, 95 % CI 1.059-8.358; p = 0.038), and stress (HR 4.922, 95 % CI 1.06-22.848; p = 0.042) were linked to long-term survival. In multivariate Cox regression analyses, including known risk factors for survival in COPD, PHQ-stress (HR 45.63, 95 % CI 1.72-1,208.48; p = 0.022) remained significantly associated with survival. Conclusion: In this pilot study different dimensions of mental health were correlated to serum biomarkers, probably reflecting systemic effects of COPD. While leucocyte number and PHQ-stress were associated with long-term survival in univariate analyses, PHQ-stress remained in multivariate analyses as independent prognostic factor.
    Preview · Article · Jan 2016 · Multidisciplinary respiratory medicine
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    • "In the present study, we used the third definition as we defined psychological stress as a process by which environmental stimuli initiate cognitive and physiological reactions that ultimately can affect wellbeing. Psychological stress occurs when an individual perceives that environmental demands exceed his or her adaptive capacity[16]. The aim of the present study was to investigate the association between pain in the neck and shoulders, stress and work ability measured by the WAI. "
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    ABSTRACT: Musculoskeletal pain and stress-related disorders are leading causes of impaired work ability, sickness absences and disability pensions. However, knowledge about the combined detrimental effect of pain and stress on work ability is lacking. This study investigates the association between pain in the neck-shoulders, perceived stress, and work ability. In a cross-sectional survey at a large pharmaceutical company in Denmark 473 female laboratory technicians replied to questions about stress (Perceived Stress Scale), musculoskeletal pain intensity (scale 0–10) of the neck and shoulders, and work ability (Work Ability Index). General linear models tested the association between variables. In the multi-adjusted model, stress (p < 0.001) and pain (p < 0.001) had independent main effects on the work ability index score, and there was no significant stress by pain interaction (p = 0.32). Work ability decreased gradually with both increased stress and pain. Workers with low stress and low pain had the highestWork Ability Index score (44.6 (95% CI 43.9–45.3)) and workers with high stress and high pain had the lowest score (32.7 (95% CI 30.6–34.9)). This cross-sectional study indicates that increased stress and musculoskeletal pain are independently associated with lower work ability in female laboratory technicians.
    Full-text · Article · Dec 2015 · International Journal of Environmental Research and Public Health
    • "Levels of glucocorticoids (GCs; steroid hormones released by the adrenal cortex) at baseline serve critical metabolic functions, but increase following activation of the hypothalamic–pituitary–adrenal (HPA) axis in response to real or perceived stressors, both acute and chronic (Charmandari et al., 2005). Chronic exposure to GCs can deleteriously affect health and cognitive function in humans and animals (Cohen et al., 2007; McEwen and Sapolsky, 1995; McEwen and Wingfield, 2003; Roozendaal et al., 2009; Sheriff et al., 2009). Acute activation of the HPA axis facilitates physiological and behavioral changes that redirect energy away from processes not essential for immediate survival, such as reproduction, and toward processes and behaviors that may enhance survival, such as glucose mobilization, antipredator behaviors, and memory consolidation (reviewed by Sapolsky et al., 2000; Wingfield and Ramenofsky, 1999). "

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