title: The effects of a psychoneuroimmunology (PNI) based lifestyle intervention in modifying the progression of depression in clinically depressed adults.
abstract: OBJECTIVE
  Uncontrolled stress can lead to poorly controlled upsurges of cortisol and deregulation of the hypothalamus pituitary-adrenal axis (HPA), thereby leading to major depression. Psychoneuroimmunology (PNI) is the area of medicine dealing with the bidirectional pathways connecting the influences of brain, neuroendocrine, and immune system. Individual PNI-based lifestyle interventions such as humor and guided imagery have been shown to modulate the stress response. However, researchers have not examined the composite effect of a PNI-based lifestyle intervention among clinically depressed adults.
  
  
  METHODS
  This randomized interventional study examined the composite effect(s) of a PNI-based lifestyle intervention: progressive muscle relaxation, spiritual guided imagery, and humor as an adjunct therapy to modifying the progression of depression. Forty-one participants recruited from doctors' offices in San Bernardino and Riverside counties in Southern California, were randomized into two groups: treatment (N = 20) and control (N = 21). For a period of three weeks, participants in the treatment group listened to a 12-minute progressive muscle relaxation and spiritual guided imagery CD daily and watched 10 minutes of humorous DVDs. Participants in both groups were also receiving cognitive behavioral therapy and pharmacotherapy.
  
  
  RESULTS
  Depression, spirituality, humor, and stress were assessed at baseline and week 3. Depression significantly decreased from severe to mild from baseline to week 3 in the treatment group. Spirituality significantly increased in the treatment group but remained unchanged in the controls.
  
  
  CONCLUSIONS
  These findings offer depressed patients alternative approaches to preventing complications and managing their illness in the context of whole-person lifestyle optimization and integration of mind-body-spirit.
authors.affiliation: Preventive Care and Wellness Services, San Bernardino, California 92401, USA. DrRuth@PreventiveLifestyle.com
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Tanyi
authors.forename: Lee S
authors.initials: LS
authors.lastname: Berk
authors.forename: Jerry W
authors.initials: JW
authors.lastname: Lee
authors.forename: Kendal
authors.initials: K
authors.lastname: Boyd
authors.forename: Adam
authors.initials: A
authors.lastname: Arechiga
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D015444:Exercise / Q000523:psychology; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D019018:Imagery, Psychotherapy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011598:Psychoneuroimmunology; D012064:Relaxation Therapy; D026443:Spiritual Therapies; D014925:Wit and Humor as Topic; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents