Key News in Family Medicine April 16, 2019 (1 of 3)

Losing a loved one is, of course, incredibly traumatic. it can also shorten the life. A recent article reviews several decades of research into bereavement and its effects on the immune system.

For years, researchers and non-specialists have found that the risk of mortality increases significantly when someone loses a partner. Formerly, we might have called it dead with a broken heart. The phenomenon has been under study for decades.

For example, researchers using data from a Finnish population published their findings in 1987. They found that "For all natural causes, mortality during the first week [following the death of a spouse] was more than twice the expected rates. "

Another study, published in 1995, found that after the death of a spouse, mortality "was significantly high among men and women". This elevation was most pronounced 7 to 12 months after death. Although scientists have gathered extensive evidence demonstrating this effect, there is less information on the biological mechanism that motivates it.

Mourning and the immune system

Now, a review of the literature has tried to link the previous results to give a clearer picture of this phenomenon. Specifically, the authors looked at how grief and bereavement could negatively influence the immune system, increasing the risk of death. The authors, from the University of Arizona at Tucson, recently published their article in the journal Psychosomatic medicine.

Researchers conducted a systematic review of published research from 1977 to the present day. In all, 33 studies obtained the score to be considered for the badysis and the scientists focused on the 13 studies of the highest quality.

When asked why they had conducted the research, one of the authors, Lindsey Knowles, explained, "There is strong evidence that marital mourning increases morbidity and early mortality risk at home." widows and widows, however, it remains to be discovered impact on health. "

It was in the late 1970s that scientists began to look into the role of the immune system in increasing the risk of death after bereavement. An article published in The lancet in 1977 claims to be the first to measure an abnormality of immune function following a bereavement.

A new examination of the evidence

Knowles explains that she wanted to create a document that includes "all published data on the badociation between grief and immune function – in order to establish a knowledge base and to suggest specific guidance for future research ".

The document presents the main results of the studies conducted to date. In particular, they indicate that the bereaved have increased levels of inflammation, a defective expression of the immune cell gene and a reduced immune response to immune challenges.

These changes are all significant in trying to understand why people in mourning have a higher risk of death. For example, scientists already know that chronic inflammation plays a role in many diseases, including obesity, heart disease, and diabetes. The authors also concluded that there was a link between the psychological effects of grief – such as bereavement and depression – and the severity of the impact of bereavement on immune function.

A study published in 1994, for example, found that, overall, the profiles of immunity of people in mourning did not have significant differences. However, those who also met the diagnostic criteria for depression had impaired immune function.

This type of research is important. There is always a mysterious air around the subject, so any new idea is essential. Scientists know that grief increases the risk of premature death. Therefore, understanding what is happening on a physiological basis could help guide how physicians treat these people in the future.

Mary-Frances O 'Connor, Associate Professor, explains how "one day, clinicians may be able to track the evolution of patient immunity and prevent medical complications after this difficult experience." Asked about the contribution of this document to the field, O Connor said: "This systematic review gives researchers a resource to read all of this research in one place, with a modern perspective on how the field has changed. and a visual model to help move the field forward in a more organized way. "

Although this research track has a long history, scientists still need to fill many gaps with new research. As the authors explain, large longitudinal studies are needed. For example, if researchers could badess an individual's immune profile before mourning occurred and throughout its aftermath, this would provide an indispensable depth of information. Of course, this approach would require a lot of resources. Hopefully this review will spark a fascination in the next generation of researchers who are destined to address this topic.