Psychoneuroimmunology and psychosomatic medicine: back to the future.
OBJECTIVE
Although psychological modulation of immune function is now a well-established phenomenon, much of the relevant literature has been published within the last decade. This article speculates on future directions for psychoneuroimmunology research, after reviewing the history of the field.


METHODS
This review focuses on human psychoneuroimmunology studies published since 1939, particularly those that have appeared in Psychosomatic Medicine. Studies were clustered according to key themes, including stressor duration and characteristics (laboratory stressors, time-limited naturalistic stressors, or chronic stress), as well as the influences of psychopathology, personality, and interpersonal relationships; the responsiveness of the immune system to behavioral interventions is also addressed. Additionally, we describe trends in populations studied and the changing nature of immunological assessments. The final section focuses on health outcomes and future directions for the field.


RESULTS
There are now sufficient data to conclude that immune modulation by psychosocial stressors or interventions can lead to actual health changes, with the strongest direct evidence to date in infectious disease and wound healing. Furthermore, recent medical literature has highlighted a spectrum of diseases whose onset and course may be influenced by proinflammatory cytokines, from cardiovascular disease to frailty and functional decline; proinflammatory cytokine production can be directly stimulated by negative emotions and stressful experiences and indirectly stimulated by chronic or recurring infections. Accordingly, distress-related immune dysregulation may be one core mechanism behind a diverse set of health risks associated with negative emotions.


CONCLUSIONS
We suggest that psychoneuroimmunology may have broad implications for the basic biological sciences and medicine.
Kiecolt-Glaser
Janice K
JK
Department of Psychiatry, Ohio State University, Columbus, OH 43210, USA. kiecolt-glaser.1@osu.edu
McGuire
Lynanne
L
Robles
Theodore F
TF
Glaser
Ronald
R
D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D020031:Epstein-Barr Virus Infections / Q000276:immunology; D005544:Forecasting; D006680:HLA Antigens / Q000276:immunology; D015438:Health Behavior; D006561:Herpes Simplex / Q000276:immunology; D006801:Humans; D007136:Immunoglobulins / Q000276:immunology; D007378:Interleukins / Q000276:immunology; D007398:Interpersonal Relations; D007694:Killer Cells, Natural / Q000276:immunology; D008016:Life Change Events; D008875:Middle Aged; D010835:Phytohemagglutinins / Q000276:immunology; D011598:Psychoneuroimmunology / Q000639:trends*; D011602:Psychophysiologic Disorders / Q000276:immunology* / Q000378:metabolism; D011611:Psychosomatic Medicine / Q000639:trends*; D013313:Stress Disorders, Post-Traumatic / Q000276:immunology; D014945:Wound Healing / Q000276:immunology
D006680:HLA Antigens; D007136:Immunoglobulins; D007378:Interleukins; D010835:Phytohemagglutinins; D002097:C-Reactive Protein