| Abstract [eng] |
Autoimmune diseases are chronic conditions whose onset and course are determined by the interaction of genetic, immunological, environmental, and psychosocial factors. A review of the literature has shown that the association between autoimmune diseases and mental disorders is described in both epidemiological directions: individuals with mental disorders are more likely to be diagnosed with autoimmune conditions, while patients with autoimmune diseases more frequently experience depression, anxiety, and other psychiatric symptoms. These associations are not uniform across all disease groups. In rheumatoid arthritis, the link is more strongly related to pain, fatigue, and functional impairment; in the context of systemic lupus erythematosus, a broader spectrum of neuropsychiatric and cognitive disturbances is observed; whereas in celiac disease, the daily psychosocial burden associated with long-term adaptation to the illness becomes particularly important. The mechanisms underlying these associations are most often explained by psychoneuroimmunological processes, including alterations in hypothalamic–pituitary–adrenal (HPA) axis activity, imbalance of the autonomic nervous system, the effects of inflammatory cytokines on the central nervous system, and neuroinflammatory processes. These mechanisms help explain how psychological stress may be associated with increased inflammatory activity, while immune alterations may contribute to changes in emotional state, cognition, and pain perception. The review also demonstrated that the risk and course of autoimmune diseases are associated with a broader social and environmental context. Social determinants, lifestyle factors, and biological environmental influences may all play a role; however, their impact is not uniform across the spectrum of autoimmune diseases and depends on the specific condition and the population studied. Non-pharmacological interventions — particularly psychotherapeutic and psychoeducational approaches, physical activity, and social support measures — are generally associated with improved psychological well-being, better adaptation to the disease, reduced pain and fatigue, and improved functional status. However, the evidence supporting the effectiveness of these interventions remains inconsistent. The included studies varied in methodology, assessment tools, and study populations; therefore, this review primarily reflects general trends in the field and indicates that the psychosocial aspects of autoimmune diseases are clinically significant, although their evaluation requires more high-quality research. |
