Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Dissociation and Immune Dysregulation: A Preliminary Report


Recent evidence indicates that various types of interactions between nervous and immune system are important in pathogenesis of depression. These findings show that a significant role in developing depression play proinflammatory cytokines that may mediate its psychological and neurobiological manifestations. Great importance among these cytokines plays tumor necrosis factor alpha (TNF-a) and there is growing evidence that inflammatory processes related to depression may be influenced by psychological stress as well as organic inflammatory conditions. These findings suggest that specific influences related to traumatic stress and dissociation could be found in close relationship to increased level of cytokine TNF-a. In the present study we have performed psychometric measurement of depression (BDI-II), traumatic stress symptoms (TSC-40) and dissociation (DES), and immunochemical measure of serum TNF-a in 40 inpatients with unipolar depression (mean age 38.4±8.2). The results show that TNF-a is significantly related to DES (Spearman R= -0.36, p<0.05), but not to BDI-II and TSC-40. Results of the present study suggest that TNF-a alterations related to dissociation could present a specific process of immunomodulation that may be explained by mutual influences between stress and neuroimmune system.


  1. Altemus, M., Rao, B., Dhabhar, F.S., Ding, W. & Granstein, R.D. (2001). Stress-induced changes in skin barrier function in healthy women. Journal of Investigative Dermatology, 117, 309–317.

  2. American Psychiatric Association. (1994). DSM IV, Diagnostic and Statistical Manual of Mental Disorders. Washington DC: American Psychiatric Association.

  3. Beck, A.T., Steer, R.A. & Brown, G.K. (1996). Manual for Beck Depression Inventory- II. San Antonio, TX: Psychological Corporation.

  4. Bernstein, E.M. & Putnam, F.W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease, 174, 727–735.

  5. Bizik, G. (2010). Meta-analysis of plasma interleukine-6 levels in patients with depressive disorder. Activitas Nervosa Superior, 52, 76–80.

  6. Bob, P., Fedor-Freybergh, P., Jasova, D., Susta, M., Pavlat, J., Zima, T., Benakova, H., Bizik, G., Svetlak, M., Vevera, J., Miklosko, J., Hajek, K. & Raboch, J. (2008). Depression, cortisol and somatoform dissociative symptoms. Neuroendocrinology Letters, 29, 235–239.

  7. Bob, P., Susta, M., Gregusova, A. & Jasova, D. (2009). Dissociation, cognitive conflict and nonlinear patterns of heart rate dynamics in patients with unipolar depression. Progress in Neuropsychopharmacology and Biological Psychiatry, 33, 141–145.

  8. Briere, J. Psychometric review of the Trauma Symptom Checklist-40. In: Stamm BH, editor. (1996). Measurement of stress, trauma, and adaptation. Lutherville: Sidran Press.

  9. Maes, M., Ombelet, W., De Jongh, R., Kenis, G. & Bosmans, E. (2001). The inflammatory response following delivery is amplified in women who previously suffered from major depression, suggesting that major depression is accompanied by a sensitization of the inflammatory response system. Journal of Affective Disorder, 63, 85–92.

  10. Maes, M., Song, C., Lin, A., De Jongh, R., Van Gastel, A., Kenis, G., Bosmans, E., De Meester, I., Neels, I.B., Demedts, P., Janca, A., Scharpe, S. & Smith, R.S. (1998). The effects of psychological stress on humans: increased production of pro-inflammatory cytokines and a Thl-like response in stress-induced anxiety. Cytokine, 10, 313–318.

  11. Maes, M., Yirmyia, R., Noraberg, J., Brene, S., Hibbeln, J., Perini, G., Kubera, M., Bob, P., Leler, B. & Maj, M. (2009). The inflammatory & neurodegenerative (I&ND) hypothesis of depression: leads for future research and new drug developments in depression. Metabolic Brain Disease, 24, 27–53.

  12. Nijenhuis, E.R., Spinhoven, P., Vanderlinden, J., van Dyck, R. & van der Hart, O. (1998). Somatoform dissociative symptoms as related to animal defensive reactions to predatory imminence and injury. Journal of Abnormal Psychology, 107, 63–73.

  13. Patel, T., Brewin, C.R., Wheatley, J., Wells, A., Fisher, P. & Myers, S. (2007). Intrusive images and memories in major depression. Behavior Research and Therapy, 45, 2573–2580.

  14. Post, R.M. (1992). Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. American Journal of Psychiatry, 149, 999–1010.

  15. Post, R.M. (2007). Kindling and sensitization as models for affective episode recurrence, cyclicity, and tolerance phenomena. Neuroscience and Biobehavioral Review, 31, 858–873.

  16. Raboch, J., Anders, M., Prasko, J. & Hellerova, P. (2006). Recommended procedures in psychiatric care (Doporucené postupy psychiatrické péce II). Praha: Infopharm.

  17. Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E., Hergueta, T., Baker, R. & Dunbar, G.C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, Suppl 20:22–33; quiz 4–57.

  18. Schiepers, O.J., Wichers, M.C. & Maes, M. (2005). Cytokines and major depression. Progress in Neuropsychopharmacology and Biological Psychiatry, 29, 201–217.

  19. Schore, A.N. (1994) Affect Regulation and the Origin of the Self. New Jersey: Lawrence Erlbaum Associates.

  20. Schore, A.N. (2001). The effects of early relational trauma on right brain developmnent, a ffect regulation and infant mental health. Infant Mental Health Journal, 22, 201–269.

  21. Song, C. Cytokines, Stress, and Depression: A Mechanism Involving Corticotropin -Releasing Factor. In: Fing, G., editor. Encyclopedia of stress. (2000). San Diego: Academic Press, p. 633–638.

  22. van der Kolk, B., Greenberg, M., Boyd, H. & Krystal, J. (1985). Inescapable shock, neurotransmitters, and addiction to trauma: toward a psychobiology of post traumatic stress. Biological Psychiatry, 20, 314–325.

  23. Wichers, M. & Maes, M. (2002). The psychoneuroimmuno-pathophysiology of cytokine-induced depression in humans. International Journal of Neuropsychopharmacology, 5, 375–88.

Download references

Author information

Correspondence to Gustav Bizik.

Rights and permissions

This article is published under an open access license. Please check the 'Copyright Information' section for details of this license and what re-use is permitted. If your intended use exceeds what is permitted by the license or if you are unable to locate the licence and re-use information, please contact the Rights and Permissions team.

About this article

Verify currency and authenticity via CrossMark

Cite this article

Bizik, G., Bob, P., Raboch, J. et al. Dissociation and Immune Dysregulation: A Preliminary Report. Act Nerv Super 53, 141–145 (2011).

Download citation

Key words

  • depression
  • dissociation
  • TNF-alpha
  • traumatic stress