Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-27T18:49:25.678Z Has data issue: false hasContentIssue false

Significant alterations in peripheral blood lymphocyte subsets in patients with somatoform disorder

Published online by Cambridge University Press:  24 June 2014

Francisco Pedrosa Gil*
Affiliation:
Psychosomatic Out-Patient Clinic, Department of Internal Medicine Innenstadt, Ludwig Maximilians University, Munich, Germany
Markus J Schwarz
Affiliation:
Hospital of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
Norbert Müller
Affiliation:
Hospital of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
Marius Nickel
Affiliation:
University Clinic for Psychosomatics and Psychotherapy, Medical University Graz, Bad Aussee, Austria
Nathan Ridout
Affiliation:
Clinical and Cognitive Neurosciences Institute, School of Life and Health Sciences, Aston University, Birmingham, UK
Ralf Schmidmaier
Affiliation:
Department of Haematology and Oncology, Department of Internal Medicine Innenstadt, Ludwig Maximilians University, Munich, Germany
*
Francisco Pedrosa Gil, MD, Psychosomatic Out-patient-Clinic, Department of Internal Medicine Innenstadt; Ludwig-Maximilians-University; Pettenkoferstrasse 10, D-80336 Munich, Germany. Tel: +49 89 5160 3572; Fax: +49 89 5160 4751; E-mail: [email protected]

Abstract

Objective:

Previous studies have suggested that somatoform disorders (SFD) might be associated with changes in the function of the central and autonomic nervous systems. The aim of this study was to examine the possible immunological differences between SFD and healthy controls.

Methods:

Twenty-four patients with SFD and 13 healthy individuals completed the psychological questionnaires to assess symptom reporting [Symptom Checklist-90 Revised (SCL-90-R)] and to diagnose for SFD [Screening for Somatoform Symptoms scale (SOMS-scale)]. Participants also provided a blood sample taken in the morning, which was analysed with an automated cell counter to determine the number of leucocytes per μl and with flow cytometry to determine lymphocyte subsets.

Results:

With the exception of a higher T4/T8 ratio in the patient group, which was mainly because of lower CD8 counts, there were no significant differences in the absolute number of lymphocytes (subsets) between patients with SFD and healthy subjects. A positive correlation between B-lymphocyte subsets (CD19+CD22+, CD19+CD5+, CD19+CD3−) to all scales of the SCL-90-R, except somatisation, were found in SFD. Additionally, a positive correlation was found in SFD between CD14+CD16+ monocytes and somatisation (0.573) on the SCL-90-R scale.

Conclusion:

These data indicate that patients with SFD have an enhanced humoral immunity as shown by increased B-cell numbers and furthermore an elevated T4/T8 ratio because of lower CD8 suppressor cells. Further studies will be required to determine whether these alterations in lymphocyte subsets are directly involved in the pathophysiology of SFD.

Type
Research Article
Copyright
Copyright © 2007 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ustun, TB, Sartorius, N, eds. Mental illness in general health care. Chichester, UK: John Wiley, 1995. Google Scholar
Hiller, W, Rief, W, Brahler, E. Somatisation in the population: from mild bodily misperceptions to disabling symptoms. Soc Psychiatry Psychiatr Epidemiol 2006;41 (9):704712. CrossRefGoogle ScholarPubMed
Rief, W, Henningsen, P, Hiller, W. Classification of somatoform disorders. Am J Psychiatry 2006;163:746747. CrossRefGoogle ScholarPubMed
Schaefer, M, Stein, C. Control of pain in peripheral tissues by cytokines and neuropeptides. In: Plotnikoff, NP, Faith, RE, Murgo, AJ, Good, RA eds. Cytokines, stress and immunity. Boca Raton, FL: CRC press, 1999: 261270. Google Scholar
Rief, W, Pilger, F, Ihle, D, Verkerk, R, Scharpe, S, Maes, M. Psychobiological aspects of somatoform disorders: contributions of monoaminergic transmitter systems. Neuropsychobiology 2004;49:2429. CrossRefGoogle ScholarPubMed
Rief, W, Barsky, AJ. Psychobiological perspectives on somatoform disorders. Psychoneuroendocrinology 2005;30:9961002. CrossRefGoogle ScholarPubMed
Rief, W, Pilger, F, Ihle, D, Bosmans, E, Egyed, B, Maes, M. Immunological differences between patients with major depression and somatisation syndrome. Psychiatric Res 2001;105:165174. CrossRefGoogle ScholarPubMed
Dantzer, R. Somatisation: a psychoneuroimmune perspective. Psychoneuroendocrinology 2005;30:947952. CrossRefGoogle ScholarPubMed
Yolken, RH, Torrey, EF. Viruses, schizophrenia and bipolar disorder. Clin Microbiol Rev 1995;8:131145. CrossRefGoogle ScholarPubMed
Muller, N, Schwarz, MJ. Neuroimmune-endocrine crosstalk in schizophrenia and mood disorders. Expert Rev Neurother 2006;6:10171038. CrossRefGoogle ScholarPubMed
Haack, M, Hinze-Selch, D, Fenzel, Tet al. Plasma levels of cytokines and soluble cytokine receptors in psychiatric patients upon hospital admission: effects of confounding factors and diagnosis. J Psychiatric Res 1999;33:407418. CrossRefGoogle ScholarPubMed
Dantzer, R, Bluthe, RM, Laye, S, Bret-Dibat, JL, Parnet, P, Kelley, KW. Cytokines and sickness behaviour. Ann NY Acad Sci 1998;840:586590. CrossRefGoogle Scholar
Vollmer-Conna, U. Acute sickness behaviour; an immune system-to-brain communication? Psychol Med 2001;31:761767. CrossRefGoogle ScholarPubMed
Maes, M, Smith, R, Scharpe, S. The monocyte-T-lymphocyte hypothesis of major depression. Psychoneuroendocrinology 1995;20:111116. CrossRefGoogle ScholarPubMed
Hiller, W, Zaudig, M, Mombour, W. International diagnostic checklists for ICD-10 and DSM-IV (Handbook). Seattle: Hogrefe & Huber-Verlag, 1996. Google Scholar
Rief, W, Hiller, W, Heuser, J. SOMS- Das Screening für Soamatoforme Störungen Manual zum Fragebogen [SOMS-Screening for omatoform symptoms. Manual for the self-rating scale]. Bern: Hans Huber-Verlag, 1997. Google Scholar
Derogatis, LR. SCL-90-R. Self-report symptom inventory. In: Franke, G, ed. Collegium Internationale Psychiatriae Scalarum: Internationale Skalen für Psychiatrie. Weinheim: Beltz-Verlag, 1994. Google Scholar
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:5662. CrossRefGoogle ScholarPubMed
Hautzinger, M, Bailer, M, Worall, Het al. Beck Depressions Inventar (BDI), 2. überarbeitete Aufl. Göttingen: Hogrefe-Verlag, 1995. Google Scholar
Maier, W, Falkai, P. The epidemiology of comorbidity between depression, anxiety disorders and somatic diseases. Int Clin Psychopharmacol 1999;14:16. Google ScholarPubMed
Straus, SE, Fritz, S, Dale, JK, Gould, B, Strober, W. Lymphocyte phenotype and function in the chronic fatigue syndrome. J Clin Immunol 1993;13:3040. CrossRefGoogle ScholarPubMed
Masuda, A, Nozoe, SI, Matsuyama, T, Tanaka, H. Psychobehavioral and immunological characteristics of adult people with chronic fatigue and patients with chronic fatigue syndrome. Psychosom Med 1994;56:512518. CrossRefGoogle ScholarPubMed
Kronfol, Z, Silva, J, Greden, J, Dembinski, S, Gardner, R, Carrol, B. Impaired lymphocyte function in depressive illness. Life Sci 1983;33:241247. CrossRefGoogle ScholarPubMed
Irwin, M, Gillin, JC. Impaired natural killer cell activity among depressed patients. Psychiatry Res 1987;20:181182. CrossRefGoogle ScholarPubMed
Maes, M. Evidence for an immune response in major depression: a review and hypothesis. Prog Neuropsychopharmacol Biol Psychiatry 1995;19:1138. CrossRefGoogle ScholarPubMed
Sluzewska, A. Indicators of immune activation in depressed patients. Adv Exp Med Biol 1999;461:5973. CrossRefGoogle ScholarPubMed
Herbert, T, Cohen, S. Depression and immunity: a meta-analytic review. Psychol Bull 1993;113:472486. CrossRefGoogle ScholarPubMed
Pavon, L, Sandoval-Lopez, G, Eugenia Hernandez, Met al. Th2 cytokine response in major depressive disorder patients before treatment. J Neuroimmunol 2006;172 (3):156165. CrossRefGoogle ScholarPubMed
Schlatter, J, Ortuno, F, Cervera-Enguix, S. Lymphocyte subsets and lymphokine production in patients with melancholic versus nonmelancholic depression. Psychiatry Res 2004;128:259265. CrossRefGoogle ScholarPubMed
Zaharia, MD, Ravindran, AV, Griffiths, J, Merali, Z, Anisman, H. Lymphocyte proliferation among major depressive and dysthymic patients with typical or atypical features. J Affect 2000;58:110. CrossRefGoogle ScholarPubMed
Ravindran, AV, Griffiths, J, Merali, Z, Anisman, H. Circulating lymphocyte subsets in major depression and dysthymia with typical or atypical features. Psychsom Med 1998;60:283289. CrossRefGoogle ScholarPubMed
Manfro, GG, Pollack, MH, Otto, MWet al. Cell-surface expression of L-selectin (CD62L) by blood lymphocytes: correlates with affective parameters and severity of panic disorder. Depress Anxiety 2000;11:3137. 3.0.CO;2-O>CrossRefGoogle ScholarPubMed
Dayyani, F, Joeinig, A, Ziegler-Heitbrock, Let al. Autologous stem-cell transplantation restores the functional properties of CD14+CD16+ monocytes in patients with myeloma and lymphoma. J Leukoc Biol 2004;75:207213. CrossRefGoogle ScholarPubMed
Bertelsmann, W, ed. Bildung auf einen Blick. OECD. Bielefeld, Germany: Bertelsmann Stiftung, 2006. Google Scholar
Sharpe, M, Carson, AJ. “Unexplained” somatic symptoms, functional syndromes, and somatisation: do we need a paradigm shift? Ann Intern Med 2001;134:926930. CrossRefGoogle ScholarPubMed
Mayou, R, Kirmayer, LJ, Simon, G, Kroenke, K, Sharpe, M. Somatoform disorders: time for a new approach in DSM-V. Am J Psychiatry 2005;162:847855. CrossRefGoogle ScholarPubMed
Janca, A. Rethinking somatoform disorders. Curr Opin Psychiatry 2005;18:6571. Google ScholarPubMed
Sykes, R. Somatoform disorders in DSM-IV: mental or physical disorders? J Psychosom Res 2006;60:341344. CrossRefGoogle ScholarPubMed
Mayou, R, Bass, C, Sharpe, M. Overview of epidemiology classification and aetiology, In: Mayou, R, Bass, C, Sharpe, M, eds. Treatment of functional somatic symptoms. London: Oxford University Press, 1995, 4265. CrossRefGoogle Scholar
Pollmächer, T, Haack, M, Schuld, A, Kraus, T, Hinze-Selch, D. Effects of antipsychotic drugs on cytokine networks. J Psychiat Res 2000;34:369382. CrossRefGoogle ScholarPubMed
Hinze-Selch, D, Schuld, A, Kraus, T. Effects of antidepressants on weight and on the plasma levels of leptin, TNF-α and soluble TNF receptors: a longitudinal study in patients treated with amitryptiline or paroxetine. Neuropsychopharmacol 2000;23:1319. CrossRefGoogle ScholarPubMed