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Psychosocial Interventions Appear to Enhance Immune System Function

June 25, 2020

Psychosocial interventions are reliably associated with improved immunity and, consequently, appear to be a feasible way to improve immune-related health, according to a systematic review and meta-analysis published online in JAMA Psychiatry.

“Specifically, we found that psychosocial interventions were associated with improvements in immune system function over time—in particular, with decreased proinflammatory cytokines or markers and increased immune cell counts—and that these associations were most consistent for interventions that incorporate cognitive behavior therapy (CBT) or multiple interventions,” researchers wrote.

The analysis included 56 randomized controlled trials involving 4060 participants. Researchers focused on 8 psychosocial interventions (behavior therapy, cognitive therapy, CBT, CBT plus additive treatment or mode of delivery that augmented the CBT, bereavement or supportive therapy, multiple or combined interventions, other psychotherapy, and psychoeducation), 7 immune outcomes (proinflammatory cytokines and markers, anti-inflammatory cytokines, antibodies, immune cell counts, natural killer cell activity, viral load, and other immune outcomes), and various factors that could potentially moderate associations, such as individual or group sessions and the reason for receiving treatment. 

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Random assignment to a psychosocial intervention, according to the meta-analysis, was linked with a 14.7% boost in beneficial immune system function and an 18% drop in harmful immune system function compared with a control condition. Associations were robust across age, sex, and intervention length and lasted for at least 6 months. 

“In comparison, a randomized controlled trial found that, relative to a control group, treatment with a 40-mg dose of darapladib for reducing cardiovascular disease risk decreased interleukin-6 levels by 7.8% and C-reactive protein levels by 6.0%, whereas a 160-mg dose of darapladib decreased interleukin-6 levels by 12.3% and C-reactive protein levels by 13.0%,” researchers wrote. “Psychosocial interventions thus appear to reduce systemic inflammatory activity in a manner that is similar to using darapladib for treating atherosclerosis.”

The most reliable associations occurred with CBT, multiple or combined interventions, and studies that looked at proinflammatory cytokines or markers, researchers reported.

“Given the effectiveness and relative affordability of psychosocial interventions for treating chronic disease, we suggest that psychosocial interventions may represent a viable strategy for reducing disease burden and improving human health,” researchers concluded.

—Jolynn Tumolo


Shields GS, Spahr CM, Slavich GM. Psychosocial interventions and immune system function: a systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry. 2020 June 3;[Epub ahead of print].

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