The reviews this month are an attempt to connect the dots between PNIE and other holistic areas of interest including behavior, exercise and nutrition

Townsend Letter for Doctors and Patients, Dec, 2003 by Robert A. Anderson

Psychoneuroimmunoendocrinology describes the unity of mental, neurological, hormonal and immunological functions with its many potential applications. PNIE addresses the impact of cognitive images of the mind (whatever its elusive definition) on the central nervous system and consequent interactions with endocrine and immune systems. It encompasses many arenas, including biofeedback and voluntary controls, impacts of thought and belief on physiology, past and present effects of stress on mental, emotional and physical function, placebo effects, effects of social relationships on health and disease, and impacts of "energy medicine" on personal function and that of others. This column highlights the impact of cogent studies from these arenas on the understanding of holistic medicine in the new millennium.

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Immunity and laughter

After 52 healthy men viewed a humorous video for 1 hour, increases were found in: (1) natural killer cell activity (p<0.01), immunoglobulins G (p<0.02), A (p<0.01), and M (NS), with several immunoglobulin effects lasting >12 hrs into recovery from initiation of the humor intervention; in (2) functional phenotypic markers for leukocyte subsets such as activated T cells (p<0.01), active cytotoxic T cells (p<0.01), NK cells (NS), B cells (p<0.01), helper T cells (p<0.02), uncommitted T cells with helper and suppressor markers (p<0.02) and helper/suppressor ratio (NS) with several leukocyte subset increase effects lasting 12 hours after the humor experience; in (3) cytokine interferon-[gamma] (p=0.02), with increases lasting 12 hours; in (4) total leukocytes (p<0.05), with specific subpopulation lymphocytes during the intervention (p<0.01) and 90 minutes into recovery (p<0.05); and in (5) granulocytes during the intervention (p<0.05) and 90 minutes following the intervention (p<0.01).

Berk LS, Felten DL, Tan SA et al. Modulation of neuroimmune parameters during the eustress of humor-associated mirthful laughter.Altern Ther Health Med 2001 Mar; 7(2):62-72, 74-6.

COMMENT: Modulation of numerous neuroimmune cellular and chemical parameters during and following the humor-associated eustress of laughter may provide beneficial health effects for wellness and a complementary adjunct to whole-person integrative medicine therapies. Some have calculated that children laugh 400 times a day and adults 14 times. That was not a controlled study, but my observations would tend to confirm the sense that adults could laugh much more, and with benefit, as this study in healthy men seems to indicate. Immunity in these men was significantly strengthened after laughter, extending in many cases at least 12 hours after watching the humorous video. With all the negative information linking obesity and television watching, perhaps it's the quality of what we watch which should deserve the most attention.

Chronic illness and spiritual healing

One-hundred-nineteen patients with chronic illness (mean duration 11 years) (e.g. pain, migraine, headache, irritable bowel syndrome) were randomized to be treated by various methods of distant healing (amulet, anonymous, healer contact) over 5 months or be put on a waiting list (controls). The quality of life as evaluated by the sum of MOS SF-36 Health Survey scales improved ten points (p<0.0005) in the treated group while remaining stable and unchanged in controls. Positive expectation was significantly correlated with outcome.

Wiesendanger H, Werthmuller L, Reuter K, Walach H. Chronically ill patients treated by spiritual healing improve in quality of life: results of a randomized waiting-list controlled study. J Altern Complement Med 2001 Feb; 7(1):45-51

COMMENT: Quality of life improved in these chronically ill patients who wanted to be treated by distant healing and knew that they were treated. The study was not blinded and is subject to the criticism that the healing may have been mainly due to what happened inside the heads of the patients and had little or nothing to do with some mystical healing effect of energy treatments. Other studies have confirmed the impression that hands-on or remote healer treatments seem to have better outcomes when patients knew that a healing process was underway. This is the benefit of positive expectation. We should, however, perhaps not dismiss too quickly the possibility of replicable benefits with distant healing through prayer or other means, since other studies also indicate that those expecting to be the target of remote healing or prayer experience a lot less improvement when they are only non-prayed-for controls compared to those actually prayed for.

Intelligence and breast feeding

In 973 men and women and 2,280 men, all born in Copenhagen between October 1959 and December 1961, the duration of breast feeding was correlated with intelligence (Wechsler Adult Intelligence Scale [WAIS]) at age of 27.2 in the mixed-sex sample and at age 18.7 in the all male sample (Borge Priens Prove [BPP] test]. After adjustment for 13 potential confounders, mean full scale WAIS IQs were 99.4, 101.7, 102.3, 106.0, and 104.0 for breastfeeding durations of <1 month, 2-3 months, 4-6 months, 7-9 months, and >9 months, respectively (p=0.003). BPP scores were 38.0, 39.2, 39.9, 40.1, and 40.1 (p=0.01).