[Biopsychological relationships and prediction of the course of acute viral hepatitis].

Psychosocial factors are discussed to influence the manifestation and course of infectious diseases. The results of psychoimmunological research during the past two decades have proved that different psychosocial factors can alter a great number of immune functions. Clinical studies on the relevance of such immune alterations are still rare. The course of viral hepatitis is strictly determined by individual immune-competence, and because it is not medically treated in acute stages it offers an ideal biopsychosocial research model. In 87 patients with acute viral hepatitis we measured every week complaints, moods (German adaptation of MACL), liver and immune-function (sIL-2R, alpha IFN, IL-1Ra, IL-6). It was shown that complaints are influenced by immune activity as well as by individual psychological factors. Patients could be differentiated by symptoms ad hospital admission into three groups: 1. with mainly bodily focused symptoms, 2. with predominantly anxious-depressive symptoms and 3. with elevated moods without complaints. In the further course patients in group 2 and 3 showed more often a delayed recovery, and hence we must presumed that the coping-process in group 1 is more likely to support immune functioning, whereas coping mechanisms in groups 2 and 3 are more likely to suppress it.