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Impaired In Vivo Immune Responses in Patients with Melancholia

Published online by Cambridge University Press:  02 January 2018

Ian Hickie ,
Catherine Hickie ,
Andrew Lloyd ,
Derrick Silove  and
Denis Wakefield
Ian Hickie*
Affiliation:
Mood Disorders Unit, Division of Psychiatry, Prince Henry Hospital, Sydney, Australia, 2036
Catherine Hickie
Affiliation:
Mood Disorders Unit, Division of Psychiatry, Prince Henry Hospital, Sydney, Australia, 2036
Andrew Lloyd
Affiliation:
University of New South Wales, Department of Immunopathology, Prince Henry Hospital, Sydney
Derrick Silove
Affiliation:
University of New South Wales, Department of Immunopathology, Prince Henry Hospital, Sydney
Denis Wakefield
Affiliation:
Department of Psychiatry, Liverpool Hospital, University of New South Wales
*
∗Correspondence
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Abstract

Previous attempts to establish a relationship between impaired cell-mediated immunity (CMI) and major mood disorders have been limited by a failure to explore the relevance of depressive subcategories or to assess CMI by in vivo methods. In this case-control study CMI was assessed in 57 patients with major depression (31 with melancholic, 26 with non-melancholic disorders), and in age- and sex-matched controls by both in vitro and in vivo immunological techniques. Compared with control subjects and patients with non-melancholic depression, patients with melancholia demonstrated reduced in vivo CMI as assessed by delayed-type hypersensitivity (DTH) skin responses. Although increasing age, severity of depression, hospital admission for treatment, and reported weight loss are correlates of melancholia, none of these factors alone, or in combination, accounted for the differences in DTH responses observed between the two depressive subtypes. These data suggest that impaired CMI in vivo may be limited to those with melancholic disorders. At this stage the factors which account for this effect are unclear.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 5 , May 1993 , pp. 651 - 657
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

Albrecht, J., Helderman, J. H., Schlesser, M. A., et al (1985) A controlled study of cellular immune function in affective disorders before and during somatic therapy. Psychiatry Research, 15, 185–193.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Anderson, C. T., Roumiantzeff, M. & Kniker, W. T. (1978) The multitest system for assay of delayed type hypersensitivity (DTH) to ubiquitous antigens. Journal of Allergy & Clinical Immunology, 61, 167.Google Scholar
Besedovsky, H. O., Adriana, E. R. & Sorkin, E. (1985) Immune-neuroendocrine interactions. Journal of Immunology, 135, 750S–754S.Google Scholar
Brodaty, H., Boyce, P., Wilhelm, K., et al (1987) The establishment of a mood disorders unit. Australian & New Zealand Journal of Psychiatry, 21, 375–381.Google Scholar
Bruce, M. L. & Leaf, P. J. (1989) Psychiatric disorders and 15-month mortality in a community sample of older adults. American Journal of Public Health, 79, 727–730.Google Scholar
Cosyns, P., Maes, M., Vandewoude, M., et al (1989) Impaired mitogen-induced lymphocyte responses and the hypothalamic-pituitary-adrenal axis in depressive disorders. Journal of Affective Disorders, 16, 41–48.CrossRefGoogle ScholarPubMed
Denman, A. M. (1986) Immunity and depression. British Medical Journal, 293, 464–465.Google Scholar
Frazer, L. H., Collins, E. J., Fox, J. S., et al (1985) Assessment of delayed-type hypersensitivity in man: a comparison of the “multitest” and conventional intradermal injection of six antigens. Clinical Immunology & Immunopat hology, 35, 182–190.CrossRefGoogle Scholar
Goldberg, D. P. (1979) Manual of the General Health Questionnaire. Windsor: NFER.Google Scholar
Hall, J. G. (1985) Emotion and immunity. Lancet, ii, 326–327.Google Scholar
Hall, J. G. (1987) Depression, stress and immunity. Lancet, i, 221.CrossRefGoogle Scholar
Hall, N. R., Mcgillis, J. P., Spanoelo, B. L., et al (1985) Evidence that thymosins and other biologic response modifiers can function as neuroactive immunotransmitters. Journal of Immunology, 135, 806S–811S.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296.Google Scholar
Hickie, I., Silove, D., Hickie, C., et al (1990) Is there immune dysfunction in depressive disorders? Psychological Medicine, 20, 755–761.CrossRefGoogle ScholarPubMed
Jankovic, B. D. (1985) Neural tissue hypersensitivity in psychiatric disorders with immunological features. Journal of Immunology, 135, 853s–857s.CrossRefGoogle Scholar
Kniker, W. T., Anderson, C. T., Mcbryde, J. L., et al (1984) Multitest CMI for standardized measurement of delayed cutaneous hypersensitivity and cell-mediated immunity. Normal values and proposed scoring system for healthy adults in the USA. Annals of Allergy, 52, 75–82.Google Scholar
Lorenzi, J. (1979) Appréciation des facteurs du risque infectieux en chirurgie digestive réglee. A propos de 135 observations. These Médicine, Nice, 45, 109.Google Scholar
Maes, M., Bosmans, E. & Suy, E. (1990) Impaired lymphocyte stimulation by mitogens in severely depressed patients. A complex interface with HPA-axis hyperfunction, noradrenergic activity and the ageing process. British Journal of Psychiatry, 155, 793–798.Google Scholar
Murphy, J. M., Monson, R. R., Olivier, D. C., et al (1989) Mortality risk and psychiatric disorders. Results of a general physician survey. Social Psychiatry, 24, 134–142.Google Scholar
Parker, G., Hadzi-Pavlovic, D., Boyce, P., et al (1990) Classifying depression by mental state signs. British Journal of Psychiatry, 157, 55–65.Google Scholar
Reuben, J. M. & Hersch, E. M. (1984) Delayed hypersensitivity responses of cancer patients to recall antigens using a new “multitest” applicator. Annals of Allergy, 53, 390–394.Google Scholar
Schleifer, S. J., Keller, S. E., Bond, R. N., et al (1989) Major depressive disorder and immunity. Archives of General Psychiatry, 46, 81–88.CrossRefGoogle ScholarPubMed
Shekelle, R. B. & Raynor, W. J. (1981) Psychological depression and 17-year risk of death from cancer. Psychosomatic Medicine, 43, 117–125.Google Scholar
Smith, M. D., Smith, A., O'Donnell, J., et al (1989) Impaired delayed type hypersensitivity in rheumatoid arthritis reversed by chrysotherapy. Annals of Rheumatic Diseases, 48, 108–113.Google Scholar
Stein, M., Miller, A. H. & Trestman, R. L. (1991) Depression, the immune system, and health and illness. Archives of General Psychiatry, 48, 171–177.Google Scholar
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