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Immunologic Effects of Premenstrual Depression

其他書名	An Evaluation of the Role of Symptom Severity, Sleep Disturbances and Reproductive Hormones in Natural Killer Cell Activity
出版	University of California, San Diego and San Diego State University, 1995
URL	http://books.google.com.hk/books?id=OSuYnAv_v7sC&hl=&source=gbs_api

註釋Objective of study. Premenstrual Dysphoric Disorder (PMDD), is a disabling depressive disorder that affects an estimated 4-6% of all women. PMDD has been classified as a major depressive disorder (MDD) because PMDD and MDD demonstrate similar clinical characteristics, course and treatment response. As increasing evidence suggests that clinical depression is associated with suppressed cellular immunity, this study sought to extend these findings to a PMDD population. Sleep disturbances, overall symptom severity and reproductive hormones have been associated with immune variability; the contribution of these variables to immune variability in PMDD and healthy control women was assessed. Methods. Natural Killer (NK) cell activity, reproductive hormones, symptom severity and subjective reports of sleep disturbances were assessed in 14 PMDD and 14 healthy control women during follicular (asymptomatic) and luteal (symptomatic) endocrine phases of the menstrual cycle. To stringently evaluate the role of sleep in immune modulation, NK activity was assessed (1) before a night of partial sleep deprivation (2) following a night of partial sleep deprivation and (3) after a night of recovery sleep. Results. There were no group differences in NK activity at either menstrual cycle phase. Both PMDD and control women were found to have higher immune functioning during the luteal compared with the follicular menstrual cycle phase. Correlational results did not support the hypothesis that symptom severity and sleep disturbances would be negatively associated with NK activity. Results from the sleep deprivation intervention confirm the importance of sleep in immune modulation in that even modest decreases in sleep can suppress NK activity by as much as 45% of baseline values in both PMDD and control women. Control women's NK activity rebounded to baseline following a night of recovery sleep while PMDD women's NK activity failed to rebound and remained significantly suppressed following a night of recovery sleep, suggesting that PMDD women are less able than control women to recover from an insult to their immune system. Conclusions. Results from this study highlight the importance of considering gender and menstrual cycle phase when evaluating the influence of affective states on immune functioning and support a growing body of literature regarding the role of sleep in immune modulation.