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Psychological factors, immune function and recovery from major surgery

Published online by Cambridge University Press:  24 June 2014

Ute Vollmer-Conna ,
Kevin D. Bird ,
Bryan W Yeo ,
Philip G. Truskett ,
Reginald F. Westbrook  and
Denis Wakefield
Ute Vollmer-Conna*
Affiliation:
School of Psychiatry, University of New South Wales, Sydney, Australia
Kevin D. Bird
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia
Bryan W Yeo
Affiliation:
Department of General Surgery, Prince of Wales Hospital, Sydney, Australia
Philip G. Truskett
Affiliation:
Department of General Surgery, Prince of Wales Hospital, Sydney, Australia
Reginald F. Westbrook
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia
Denis Wakefield
Affiliation:
Inflammatory Diseases Research Unit, School of Medical Sciences, University of New South Wales, Sydney, Australia
*
Dr Ute Vollmer-Conna, Department of Human Behaviour, School of Psychiatry, University of New South Wales, Sydney 2052, Australia. Tel: +61 (02) 9385 2945; Fax: +61 (02) 9385 2944; E-mail: [email protected]
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Abstract

Objective:

This study used a prospective design and the technique of structural modelling to examine the complex interrelations between psychological factors, immune status and complications after major surgery.

Methods:

Twenty-nine women scheduled for elective cholecystectomy were studied prospectively. Information regarding medical history, health practices, life stressors, and coping strategies was obtained two weeks prior to admission. At this initial meeting, as well as three days after surgery, and at one month follow-up immunological tests were performed and the level of psychological distress was assessed. The study additionally included measures of post-operative complications, and infections and negative effect during follow-up.

Results:

Pre-operative immune status emerged as a key variable exerting strong effects on subsequent immune function and, thereby producing significant, indirect effects on every recovery variable. Pre-operative distress was directly linked to increased mood disturbance at follow-up. Moreover, distress significantly influenced immune function both before and after surgery, which mediated a significant impact on most recovery variables. Active coping behaviour directly increased the risk of a complicated recovery.

Conclusions:

The study demonstrated that distress-induced changes in immune functioning have clinical relevance. Overall, the present findings suggest that recovery from surgery is facilitated in patients with a well-functioning immune system, a low-level of pre-operative distress and a passive coping disposition.

Keywords

copingimmunitypsychological distresssurgery
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 21 , Issue 4 , August 2009 , pp. 169 - 178
Copyright
Copyright © 2009 John Wiley & Sons A/S

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