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August 1990

A Structured Psychiatric Intervention for Cancer Patients: II. Changes Over Time in Immunological Measures

Author Affiliations

From the Departments of Psychiatry (Drs Fawzy and Kemeny, Mr Cousins, and Ms Fawzy), Microbiology and Immunology (Drs Kemeny and Fahey), and Biomathematics (Dr Elashoff), the Dean's Office (Mr Cousins), the John Wayne Cancer Clinic/Division of Surgical Oncology (Dr Morton), the Center for Interdisciplinary Studies in Immunology and Disease (Dr Fahey), and the Jonsson Comprehensive Cancer Center (Drs Fawzy, Elashoff, Morton, and Fahey and Mr Cousins), UCLA School of Medicine.

Arch Gen Psychiatry. 1990;47(8):729-735. doi:10.1001/archpsyc.1990.01810200037005

• We evaluated the immediate and long-term effects on immune function measures of a 6-week structured psychiatric group intervention for patients with malignant melanoma. Along with a reduction in levels of psychological distress and greater use of active coping methods, the following immune changes were seen at the 6-month assessment point in the interventiongroup patients (n 35) compared with controls (n = 26): significant increases in the percent of large granular lymphocytes (defined as CD57 with Leu-7) and natural killer (NK) cells (defined as CD16 with Leu-11 and CD56 with NKH1) along with indications of increase in NK cytotoxic activity; and a small decrease in the percent of CD4 (helper/inducer) T cells. At the 6-week follow-up point, the majority of these changes were not yet observable. The results indicate that a short-term psychiatric group intervention in patients with malignant melanoma with a good prognosis was associated with longer-term changes in affective state, coping, and the NK lymphoid cell system. Affective rather than coping measures showed some significant correlations with immune cell changes.