Stress and Psychoneuroimmunologic Factors in Dermatology
Section snippets
Interventions
PNI intervention studies involve different strategies, including hypnosis, relaxation, exercise, classical conditioning, self-disclosure, exposure to a phobic stressor to enhance perceived coping self-efficacy, and cognitive-behavioral therapies with a range of populations [22]. One excellent series of studies demonstrates that 10-week cognitive-behavioral stress management and aerobic-exercise training programs buffer distress responses and immune alterations [23], [24], [25].
How do psychologic factors influence immune function?
The endocrine system serves as a central gateway for psychologic influences on health. Stress and depression can cause the release of pituitary and adrenal hormones that have multiple effects on immune function [26]. For example, negative emotions may also indirectly contribute to immune dysregulation evidenced by proinflammatory cytokine overproduction and repeated chronic or slow-resolving infections or wounds that enhance the secretion of proinflammatory cytokines—a process leading to
Personality and coping
Personality and coping styles reflect individual differences in appraisal and response to stressors that may influence immune function. Reflecting the broader field of psychosomatic medicine at the time, much of the work before 1970 attempted to link personality traits to various diseases. For example, some researchers attempted to identify personality variables that predisposed individuals to allergic disorders [40], [41], [42]; skin reactivity to injected allergens (ie, wheal and flare size)
Psychoneuroimmunology in dermatology
Mental and psychic issues are also important in the genesis or development of many diseases. The psychologic or psychiatric genesis of a skin disease, however, still remains one of the most debated and controversial arguments present in contemporary medicine and academia. This controversy is in part due to the ease with which a poorly understand and hard to treat disease can be labeled as having “psychosomatic pathogenesis”. Labeling occurs often in dermatology because it is a field in which
Summary
Clinical and experimental data supports the brain's ability to start, influence, and stop biologic events in the skin. The skin, as a relevant part of the diffuse brain, can modify the quality of perceptions and feelings, as suggested by relevant studies. The immune and the endocrine systems may act as protagonists of the modulation of these events and, in this context, psychosocial stressors and interventions can lead to global health changes of great interest to dermatologists.
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