Abstract
Objective: The objective of this study was to examine how the chronicity of stress affects psychological stress-responses, depressive symptoms, and in vivo immunocompetence in spouses of women with metastatic breast cancer.
Methods: Participants were 34 spouses of breast cancer patients. Their wives had been living with a diagnosis of recurrence metastatic breast cancer for a mean of 2.3 (SD = 3.6) years. Stress chronicity was defined as the length of time since the partner's diagnosis with metastatic breast cancer. Self-reports of psychological stress responses (IES) and depression (CES-D) were taken, and in vivo immunocompetence was assessed by delayed type hypersensitivity (DTH) responses to skin test antigens.
Results: Clinically significant levels of depressive symptoms (CES-D > 16) were reported in 15% of participants. Suppression of the DTH response was greater in men who had been living longer with an ill spouse (Spearman r = −0.39, p = 0.011), those who reported more psychological stress (r = 0.37, p = 0.16), and those who had more severe depressive symptoms (r = −0.28, p = 0.054). There was no association between the duration of disease and spouse's depression, however, those who had been living longer with an ill partner reported less psychological stress.
Conclusions: This study substantiates a relationship between depression and cell-mediated immunity in spouses with a seriously ill partner. Further, these results suggest that the duration of stress is an important factor of stress-induced immunosuppression. They also highlight the potential importance of interventions to alleviate depression among family members of cancer patients.
Acknowledgements
This study was funded by grant MH47226 from NIMH, NIMH grant 1HSA-410 and NCI, the John D. and Catherine T. MacArthur Foundation, and the Fetzer Institute.