Duygudurum ve Anksiyete Bozukluklarında Psikonöroimmünolojik Süreçler ve Psikoterapi ile İlişkisi

Öz

Duygudurum ve anksiyete bozukluklarının yaygınlık oranlarının yüksekliği ve bu bozukluklarla ilişkili işlev bozuklukları nedeniyle, bu bozuklukların daha iyi anlaşılması, önlenmesi ve tedavi edilmesi oldukça önemlidir. Psikolojik ve diğer biyolojik nedensel faktörlerin ve mekanizmaların yanı sıra, inflamatuar biyobelirteçlerin, özellikle de sitokinlerin, duygudurum ve anksiyete bozukluklarının kökeninde ve sürdürülmesinde rolü olduğu kabul edilmektedir. Buradan hareketle, birtakım çalışmalar psikoterapi müdahalelerinin sitokin düzeylerinin de dahil olduğu nöroimmünolojik parametreler üzerindeki etkisine odaklanmıştır. Bu derleme, duygudurum ve anksiyete bozuklukları ve bunların sağaltımında yaygın olarak kullanılan psikoterapi yaklaşımları ile ilişkili psikonöroimmünolojik faktörlerden, özellikle sitokin düzeylerindeki değişimleri tartışmayı hedeflemektedir. Alanyazındaki çalışmaların çoğunda ilgili bozukluklar için psikoterapi alan bireylerde özellikle pro-inflamatuar sitokinlerin düzeylerinin azaldığı gösterilirken, anti-inflamatuar sitokinlerin düzeylerinin ise yükseldiği bildirilmiştir. Yine de çalışma desenlerinin çeşitliliği çalışmalar arasında bulguların kıyaslanmasında ve çalışmaların çoğunun kesitsel desene sahip olması psikiyatrik semptomatoloji ve immünolojik parametreler arasındaki neden-sonuç ilişkilerinin anlaşılmasında zorluk yaratmaktadır. Psikonöroimmünoloji alanında yapılacak gelecek çalışmalarda örneklem gruplarının ve ölçüm yöntemlerinin dikkatle belirlenmesi önemlidir. Ayrıca belirli psikoterapi yaklaşımlarının anti-inflamatuar etkileri olabileceğini gösteren bulguların bu yaklaşımlara özgü olup olmadığının anlaşılması için daha fazla sayıda psikoterapi sonuç çalışmasına ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• Duygudurum bozuklukları
• kaygı bozuklukları
• psikoterapi
• inflamasyon
• sitokinler

Psychoneuroimmunological Processes in Mood and Anxiety Disorders and Their Relation with Psychotherapy

Abstract

Given high prevalence of mood and anxiety disorders and associated dysfunctions, better understanding, preventing, and treating these disorders are crucial. Along with psychological and other biological causal factors and mechanisms, inflammatory biomarkers, especially cytokines, have also been implicated in etiology and maintenance of mood and anxiety disorders. In the literature, it is generally acknowledged that there is a generalized inflammatory state in these disorders. Thus, several studies have focused on the impact of psychotherapy interventions on neuroimmunological parameters including cytokine levels. This review aims to discuss psychoneuroimmunological factors, especially changes in cytokine levels associated with mood and anxiety disorders and psychotherapy approaches which are commonly used for their treatment. Especially levels of pro-inflammatory cytokines have been shown in majority of those studies to be decreased while levels of anti-inflammatory cytokines have been reported to be elevated in individuals having psychotherapy for these disorders. Nevertheless, variability in study designs and cross-sectional designs in most studies create challenges for comparing results between studies and understanding cause-effect relationships between psychiatric symptomatology and immunological parameters. It is important to carefully determine sample groups and measurement methods in future studies in the field of psychoneuroimmunology. In addition, more studies are needed to figure out if findings showing that certain psychotherapeutic approaches can have anti-inflammatory effects are specific to those approaches or not.

Keywords

• Mood disorders
• anxiety disorders
• psychotherapy
• inflammation
• cytokines

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