title: The associations between psychosocial stress and the frequency of illness, and innate and adaptive immune function in children.
abstract: OBJECTIVE
  Family processes have a substantial impact on children's social and emotional well-being, but little is known about the effects of family stress on children's physical health. To begin to identify potential links between family stress and health in children, we examined associations between specific aspects of family psychosocial stress and the frequency of illnesses in children, measures of innate and adaptive immune function, and human herpesvirus 6 (HHV-6) reactivation.
  
  
  METHODS
  Prospective study of 169 ambulatory school-age children and parents. Parents completed multiple assessments of stress at 7 sequential six-month visits and maintained weekly illness diaries for their children over three years using a thermometer to record fever. Children had blood obtained for HHV-6 and immune function studies at each visit including natural killer (NK) cell function and the percentage of CD4 and CD8 cells associated with immune control of cytomegalovirus (CMV).
  
  
  RESULTS
  Parental psychiatric symptoms were associated with a higher frequency of illnesses: for each 1 U increase in symptom score children had an increased 1-year rate of total illnesses of 40% (rate ratio, 1.40; 95% CI, 1.06-1.85) and febrile illnesses of 77% (rate ratio, 1.77, 95% CI, 1.00-3.13). Parental psychiatric symptom scores were also associated with enhanced NK cell function (estimate, 0.15; 95% CI, 0.05-0.26) and increased percentages of CD8+CD28-CD57+ cells in the blood of CMV seropositive children (estimate, 2.57; 95% CI, 0.36-4.79). HHV-6 reactivation was not detected.
  
  
  CONCLUSIONS
  There is an association between specific psychosocial stress exposure and rates of illness and immune function in normally developing children.
authors.affiliation: Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. mary_caserta@urmc.rochester.edu
authors.forename: Mary T
authors.initials: MT
authors.lastname: Caserta
authors.forename: Thomas G
authors.initials: TG
authors.lastname: O'Connor
authors.forename: Peter A
authors.initials: PA
authors.lastname: Wyman
authors.forename: Hongyue
authors.initials: H
authors.lastname: Wang
authors.forename: Jan
authors.initials: J
authors.lastname: Moynihan
authors.forename: Wendi
authors.initials: W
authors.lastname: Cross
authors.forename: Xin
authors.initials: X
authors.lastname: Tu
authors.forename: Xia
authors.initials: X
authors.lastname: Jin
mesh_terms: D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000276:immunology; D005192:Family Health; D005260:Female; D015654:Herpesvirus 6, Human / Q000276:immunology; D006801:Humans; D007109:Immunity / Q000502:physiology*; D007113:Immunity, Innate / Q000502:physiology; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D013315:Stress, Psychological / Q000276:immunology*; D011795:Surveys and Questionnaires