The “think system” was a moderate success for Professor Harold Hill in The Music Man, but the success of “mind over matter” is hard to measure in science. Thinking healthy thoughts doesn’t make a person healthy. On the other hand, the mind is intimately connected with good health. There are countless stories of individuals who survive life-threatening injuries or recover more quickly or more completely from illness — and many credit their state of mind for their return to health.
The connection works the other way, too. Stress, depression and other mental problems are known to exacerbate medical illnesses, so a team of researchers at Washington University School of Medicine is creating a new Center for Mind/Body Research to focus particular attention on how mind/body interactions affect human health. They plan to use the center to raise awareness of the ongoing investigations at Washington University studying how mental health can affect outcomes for patients with diabetes, heart disease, cancer, chronic pain, gastrointestinal disorders, neurologic diseases, even AIDS and cancer.
Clouse says it appears that although diabetes itself is a risk factor for heart disease, the increased risk they observed in a 10-year study of depressed women with diabetes was related more to depression than to diabetes.
“We looked at the other, traditional risk factors to see whether they also were predictive of poor outcomes because we know that depression might be associated with other factors, like cigarette smoking, for example,” he says. “But when we looked at the traditional risk factors — such as obesity, high blood pressure, smoking and high cholesterol — we found that only a woman’s age and depression were significant predictors of the increased risk of heart disease that we observed in these women.”
The risks posed by depression seemed to be stronger than those imposed by the more traditional risk factors for heart disease and the other complications of diabetes. Clouse and Lustman wanted to see just how strong, so they analyzed the scientific literature, looking at every available study of diabetes and depression. They found that being depressed doubled the risk of diabetic complications, and in their study of depressed women with diabetes, they found that the risk of heart problems more than doubled.
“Just knowing that depression doubles the risk for diabetes complications didn’t tell us what was driving the chicken/egg relationship between depression and complications,” Lustman says. “It could be that people with complications are just more likely to get depressed. But by following these depressed, diabetic women and comparing them to women who had diabetes but weren’t depressed, we were able to establish that depression was, in fact, accelerating the presentation of coronary heart disease in women with diabetes.”
That increased risk is particularly important because women with diabetes are 1.5 times more likely to be depressed than diabetic men. Clouse says that fact, combined with the findings of their study, demonstrate that it’s important to look more closely at how depression and other mental disorders can negatively affect physical health.
“It’s clear from almost two decades of research that the mind can play an important role in physical health,” he says. “What’s not clear is how the mind and body interact, and frankly, there have been relatively few studies over the years that can help elucidate that connection.”
Clouse and Lustman plan to launch the new Center for Mind/Body Studies early in 2004 to encourage more research into that connection. They also want to focus on how improving mental health might improve physical health.
“The research we’re doing right now is trying to learn whether treatment can reverse some of these physiological factors, to learn whether making patients feel good might really help them have good outcomes,” Clouse says.
Clouse RE, Lustman PJ, Freedland KE, Griffith LS, McGill JB, Carney RM. Depression and coronary heart disease in women with diabetes. Psychosomatic Medicine, 65: 376-383.
This research was funded in part by grants from the National Institutes of Health, as well as the Lewis and Jean Sachs Trust.