Der Einfluß von Alltagsbelastungen und assoziierten Emotionen auf den dynamischen Verlauf von Cortisol und Neopterin bei Patientinnen mit systemischem Lupus Erythematodes : Ergebnisse aus zwei "integrativen Einzelfallstudien"1

Summary The influence of daily psychosocial stressors and associated emotions on the dyna mic course of urine Cortisol and urine neopterin in systemic lupus erythematosus: Experience taken from two „integrative single-case studies" Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by flare-ups, the cause of which is unknown. According to new stress concepts, two „integrative single-case studies" have been conducted in order to gather evidence about whether daily stressful incidents and associated emotions interfere with the dynamics of urine Cortisol and urine neopterin in SLE. Patients under study collected their urine at home, for a period of at least 50 days, on a daily basis, divided into day and night urine. Additionally, patients filled out que stionnaires twice a day to determine their emotional state, life style and disease activity. Each week, patients were examined clinically and interviewed to identify the past week's stressors using the Incidents and Hassles Inventory (IHI, Brown and Harris). Statistical analysis of the serial data was performed using time-series analysis according to Box and Jenkins. In both „integrative single-case studies" we were able to demonstrate that stressful incidents predicted an increase in urine neopterin 36 hours (Case 1) to 60 hours (Case 2) later (p < 0.05). Additionally, in Case 1 the neopterin levels were highly associated with stress resulting from the weekly examinations and interviews. Furthermore, in Ca se 2 it turned out that depending on their predictability stressful incidents were prece ded by a decrease in urine Cortisol 12 hours earlier or were followed by a decrease in urine Cortisol 36 hours later. And finally, emotional irritation was highly correlated