PSYCHOLOGICAL STRESS AND SUSCEPTIBILITY TO THE COMMON COLD
PSYCHOLOGICAL STRESS AND SUSCEPTIBILITY TO THE COMMON COLD
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DOI：
10.1056/nejm199108293250903
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发表时间：
1991-08-29
影响因子：
158.5
通讯作者：
SMITH, AP
中科院分区：
文献类型：
--
作者：
COHEN, S;TYRRELL, DAJ;SMITH, AP
背景目前尚不清楚心理压力是否会抑制宿主对感染的抵抗力。为了调查这个问题，我们前瞻性地研究了在有意暴露于呼吸道病毒的受试者中心理压力和记录的临床感冒频率之间的关系。在完成评估心理压力程度的问卷调查后，394名健康受试者被给予含有五种呼吸道病毒（鼻病毒2型，9型或14型，呼吸道合胞病毒或冠状病毒229 E型）之一的滴鼻剂，另外26名受试者被给予盐水滴鼻剂。然后对受试者进行隔离，并监测感染和症状证据的发展。临床感冒定义为通过病毒分离或病毒特异性抗体滴度增加证实存在感染的临床症状。呼吸道感染（P < 0.005）和临床感冒（P < 0.02）的发生率均随心理应激程度的增加而增加，且呈剂量-反应关系。根据心理压力水平，感染率从大约74%到大约90%不等，临床感冒的发生率从大约27%到47%不等。当我们控制了年龄、性别、教育、过敏状态、体重、季节、住在一起的受试者数量、住在一起的受试者的感染状态和基线时（攻毒前）的病毒特异性抗体状态时，这些效应没有改变。此外，所有5种攻毒病毒观察到的相关性相似。几个潜在的压力疾病介质，包括吸烟，饮酒，运动，饮食，睡眠质量，白细胞计数和总免疫球蛋白水平，并没有解释压力和疾病之间的联系。同样，控制人格变量（自尊，个人控制和内外向）未能改变我们的发现。心理压力与急性传染性呼吸道疾病风险增加呈剂量-反应关系，这种风险归因于感染率增加，而不是感染后症状频率增加。
Background. It is not known whether psychological stress suppresses host resistance to infection. To investigate this issue, we prospectively studied the relation between psychological stress and the frequency of documented clinical colds among subjects intentionally exposed to respiratory viruses.Methods. After completing questionnaires assessing degrees of psychological stress, 394 healthy subjects were given nasal drops containing one of five respiratory viruses (rhinovirus type 2, 9, or 14, respiratory syncytial virus, or coronavirus type 229E), and an additional 26 were given saline nasal drops. The subjects were then quarantined and monitored for the development of evidence of infection and symptoms. Clinical colds were defined as clinical symptoms in the presence of an infection verified by the isolation of virus or by an increase in the virus-specific antibody titer.Results. The rates of both respiratory infection (P < 0.005) and clinical colds (P < 0.02) increased in a dose-response manner with increases in the degree of psychological stress. Infection rates ranged from approximately 74 percent to approximately 90 percent, according to levels of psychological stress, and the incidence of clinical colds ranged from approximately 27 percent to 47 percent. These effects were not altered when we controlled for age, sex, education, allergic status, weight, the season, the number of subjects housed together, the infectious status of subjects sharing the same housing, and virus-specific antibody status at base line (before challenge). Moreover, the associations observed were similar for all five challenge viruses. Several potential stress-illness mediators, including smoking, alcohol consumption, exercise, diet, quality of sleep, white-cell counts, and total immunoglobulin levels, did not explain the association between stress and illness. Similarly, controls for personality variables (self-esteem, personal control, and introversion-extraversion) failed to alter our findings.Conclusions. Psychological stress was associated in a dose-response manner with an increased risk of acute infectious respiratory illness, and this risk was attributable to increased rates of infection rather than to an increased frequency of symptoms after infection.