[Psychobiology of grief and loss processing--recent immunologic and endocrinologic approaches and findings]

Recent studies demonstrate the importance of social relationships for maintaining health. As mechanisms remain hidden in ongoing relationships, much of our knowledge comes from the deleterious health consequences of loss or separation. Despite the central importance of object loss in psychosomatic models of disease, physiological links have hardly been explored. After a short review of psychological processes of mourning, recent psychoimmunological and endocrinological studies are discussed. These show fairly consistent immunosuppressive effects of depressive disorders and of impending and actual loss of the partner and endocrinological changes, also related in magnitude to depression. First results of intervention studies show favorable endocrinological and immunological changes presumably due to promotion of social relations and reduction of distress. Despite manifold methodological problems this approach provides a promising access towards understanding the meaning of social relations for physiological regulation. Decisive issues of the relationship of immunological and endocrinological changes and their clinical relevance must await further longitudinal studies which should include a more detailed psychological analysis of mourning and object relations.