PSICONEUROINMUNOLOGIA: DE LA FE Y LA PLEGARIA

Dr. Juan Rodrguez-Tafur D. Profesor Asociado de Inmunologa y Farmacologa Facultad de Medicina Universidad Nacional Mayor de San Marcos Secretario General Sociedad Peruana de Inmunologa y Alergia

 Nosotros no somos seres humanos que estan teniendo una experiencia espiritual somos seres espirituales que estan teniendo una experiencia Humana.
Pierre Teilhard de Chardin

La Ciencia sin religin es coja; y la religin sin ciencia es ciega. Albert Eistein

RELACION ENTRE LA RELIGION Y SALUD

Hay una base

biolgica

Self-Rated Religious Coping

Moderate to Large Extent 5.0-7.4

22.7% Large Extent or More 7.5-9.9 5.0% 27.3%

Small to Moderate 0.1-4.9 None 0

5.0%

40.1%

10 The Most Important Factor

Responses by 337 consecutively admitted patients to Duke Hospital (Koenig 1998)

ReliginReligion andde Bienestar en Older Adults y Sensacin Well-being in Adultos Mayores Religion1988; 28:18-28 The Gerontologist and Well-being in Older Adults
The Gerontologist1988; 28:18-28

Well-being Well-being

Low Low

Moderate Moderate

High High

Very High Very High

Church Attendance or Intrinsic Religiosity Church Attendance or Intrinsic Religiosity

Religious categories based on quartiles (i.e., low is 1st quartile, very high is 4th quartile) Religious categories based on quartiles (i.e., low is 1st quartile, very high is 4th quartile)

Religin y Depresin en Pacientes Hospitalizados Religion and Depression in Hospitalized Patients

35%

Percent Depressed

23%

22% 17%

Low

Moderate

High

Very High

Degree of Religious Coping

Geriatric Depression Scale Inf ormation based on results f rom 991 consecutiv ely admitted patients (dif f erences signif icant at p<.0001)

Time to Remisin por Intrinsic Religiosity Tiempo de Remission by Religiosidad Intrnseca

(N=87 patients with major or minor depression by Diagnostic Interview Schedule)
100%

Probability of Non-Remission

80 Low Religiosity Medium Religiosity 40 High Religiosity 20

60

0 0 10 20 30 40 50 Weeks of Followup
American Journal of Psychiatry 1998; 155:536-542

100%

845 medical inpatients > age 50 with major or minor depression

80

Probability of Non-Remission

60 Other Patients 40 Highly Religious (14%) 20 diagnosis 0 0 4 8 12 Weeks of Followup 16 20 24

HR=1.53, 95% CI=1.20-1.94, p=0.0005, after control for demographics, physical health factors, psychosocial stressors, and psychiatric predictors at baseline

Asistencia a la Iglesia y Desorden de Ansiedad Church Attendance and Anxiety Disorder

(anxiety disorder w ithin past 6 months in 2,964 adults ages 18-89)

Anxiety Disorder

Young (18-39)

Middle-Aged (40-59)

Elderly (60-97)

Koenig et al (1993). Journal of Anxiety Disorders7:321-342

Actividad Religiosa y Presin Arterial Diastlica Religious Activity and Diastolic Blood Pressure
(n=3,632 persons aged 65 or over)
Citation:InternationalJournal of Psy chiatry in Medicine 1998; 28:189-213

81
* Analyses weighted & controlled for age, sex, race, smoking, education, physical functioning, and body mass index

Average Diastolic Blood Pressure

80

79

p<.0001*

78

77
Low Attendance Low Pray er/Bible High Attendance Low Pray er/Bible Low Attendance High Pray er/Bible High Attendance High Pray er/Bible

High = weekly or more f or attendance; daily or more f or pray er Low= less than weekly f or attendance; less than once/day f or pray er

Mortality From Heart Disease and Religious Orthodoxy Mortalidad por Enfermeades Cardiacas en Religiosos Ortodoxos
(based on 10,059 civil servants and municipal employees)
Most
Differences remain significant after controlling for blood pressure, diabetes, cholesterol, smoking, weight, and baseline heart disease

Orth od

ox

No

Survival probability

n-B elie ver

Follow-up time, years

Kaplan-Meier life table curves (adapted from Goldbourt et a l 1993. Cardiology 82:100-121)

Six-Month Mortality After Open Heart Surgery Mortalidad a Seis Meses despus de Ciruga a Corazn Abierto
(232 patients at Dartmouth Medical Center, Lebanon, New Hampshire)

25
(10 of 49)

20

% Dead

15

10
(7 of 86)

(2 of 25)

5
(2 of 72)

0
Hi Religion Hi Soc Support Hi Religion Lo Soc Support Lo Religion Hi Soc Support Lo Religion Lo Soc Support

Modelo of Religion's Effects on Healthla Salud Model de los Efectos de la Religin en

Handbook of Religion and Health(Oxford University Press, 2001)

Infection
Genetic susceptibility, Gender, Age, Race, Education, Income
Childhood Training

Adult Decisions

Mental Health

Stress Hormones Cancer

Heart Disease Immune System Hypertension

Religion
Values and Character

Social Support

Autonomic Nervous System

Stroke

Adult Decisions

Health Behaviors

Disease Detection & Treatment Compliance

Stomach & Bowel Dis.

Liver & Lung Disease Accidents & STDs*

Smoking High Risk Behaviors Alcohol & Drug Use

Interleuquina 6 Asistencia a at Religious Services Serum IL-6 andyAttendance Servicios Religiosos

(1675 persons age 65 or over living in North Carolina, USA)

18

* bivariate analyses ** analyses controlled for age, sex, race, education, and physical functioning (ADLs)

Percent with IL-6 Levels >5

16 14 12 10 8 6
Never/Almost Never 1-2/yr to 1-2/mo Once/wk or more

Fre quency of Atte ndance at Re ligious Se rvice s

Citation: International Journal of Psychiatry in Medicine 1997; 27:233-250

RELACION ENTRE FE E INMUNIDAD AL VIH

Ser VIH positivo es estresante

Est la depresin asociada con una

ms rpida progresin a
38% ms prdida de clulas T CD4+ /ao Burack, JAMA, 1993

VIH?

Los hombres con mas sntomas fueron quienes se deprimieron mas. Lyketsos, JAMA, 1993

Baja progresin del VIH correlaciona con la baja densidad del receptor CCR5.
La

norepinefrina aumenta la expresin del receptor CCR5 in vitro a travs de la estimulacion del receptor de quemoquina mejorando la expansin viral

Woods and associates (1999) at the University of Miami surveyed 106 HIV-positive patients about their religious practices and measured their immune functions. Religious activities, such as prayer, religious attendance, spiritual discussions, and reading religious or spiritual literature, were associated with significantly higher CD4+ counts and CD4+ percentages. Religious coping (such as putting trust in God, seeking Gods help, or increasing praying) was related to fewer depressive symptoms as measured by the Beck Depression Inventory (p <.01) and less anxiety as measured by the Spielberger Trait Anxiety Inventory (p = .08) but not to specific immune markers. These investigators also showed that the association between religious practices and immune function was not confounded by disease progression (i.e., as disease worsened and immune function decreased, subjects became less able to participate in religious activities).

Mas frecuentes terapias alternativas complementarias usadas

y

Controles sin ejercicio mostraron significativa mayor ansiedad y depresin as como tambin una disminucin en su conteo de clulas Natural Killer.

Aquellos grupos en tratamiento con ejercicios no mostraron similar cambios y mostraron un significativo aumento en los niveles de Linfocitos CD4+

La plegaria ha sido clinicamente examinada en cohortes de pacientes VIH-negativos en lo que se refiere a la autoestima, la ansiedad, la depresin y mostraron una mejora significativa en 11 mediciones en los resultados. (OLaire, 1997)

La mayora de participantes VIH+ aumentaron su prctica de rezo desde su diagnstico de HIV.

Masaje potencia la funcin del sistema inmune por:

Reduciendo la ansiedad y el estrs Aumentando el conteo de glbulos blancos Disminuyendo los niveles de cortisol Activativando a las clulas Natural Killer.

2002

Oxford University Press 2002