ArticleBrain, behavior, and immunity2015
Depression as sickness behavior? A test of the host defense hypothesis in a high pathogen population.
Article in Brain, behavior, and immunity, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Impact of parasitic infection on mental health and illness in humans in Africa: a systematic review.Parasitology · 2022Pooled it
- A Specific Inflammatory Profile Underlying Suicide Risk? Systematic Review of the Main Literature Findings.International journal of environmental research and public health · 2020Pooled it
- Pooled it
- Not All Stress Is the Same: Variable Associations Between Psychosocial Stressors and Urinary Cortisol Rhythms in a Small-Scale Subsistence Society.American journal of human biology : the official journal of the Human Biology Council · 2026Article
- No relationship between inflammatory cytokines, heart rate variability, and morphology of the vagus nerves in patients with major depressive disorder.Brain, behavior, & immunity - health · 2025Article
- Assessing subclinical psychopathological and personality traits in a small-scale subsistence society.Evolution, medicine, and public health · 2025Article
- Depression in adolescence and young adulthood: the difficulty to integrate motivational/emotional systems.Frontiers in psychology · 2024Review
- Examining the Relationships between the Incidence of Infectious Diseases and Mood Disorders: An Analysis of Data from the Global Burden of Disease Studies, 1990-2019.Diseases (Basel, Switzerland) · 2023Article
- Evolutionary psychiatry: foundations, progress and challenges.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2023Article
- Moderators of inflammation-related depression: a prospective study of breast cancer survivors.Translational psychiatry · 2021Article
- Article
- Pathogen disgust sensitivity protects against infection in a high pathogen environment.Proceedings of the National Academy of Sciences of the United States of America · 2021Article
- Helminth infection is associated with dampened cytokine responses to viral and bacterial stimulations in Tsimane forager-horticulturalists.Evolution, medicine, and public health · 2021Article
- Sickness Behavior Score Is Associated with Neuroinflammation and Late Behavioral Changes in Polymicrobial Sepsis Animal Model.Inflammation · 2020Article
- Relationship of sanitation, water boiling, and mosquito nets to health biomarkers in a rural subsistence population.American journal of human biology : the official journal of the Human Biology Council · 2020Article
- Parental hormones are associated with crop loss and family sickness following catastrophic flooding in lowland Bolivia.Physiology & behavior · 2018Observational
- Low perceived control over health is associated with lower treatment uptake in a high mortality population of Bolivian forager-farmers.Social science & medicine (1982) · 2018Article
- The Tsimane Health and Life History Project: Integrating anthropology and biomedicine.Evolutionary anthropology · 2017Article
- Pathogen-Host Defense in the Evolution of Depression: Insights into Epidemiology, Genetics, Bioregional Differences and Female Preponderance.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2017Review
- High resting metabolic rate among Amazonian forager-horticulturalists experiencing high pathogen burden.American journal of physical anthropology · 2016Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
Sadness is an emotion universally recognized across cultures, suggesting it plays an important functional role in regulating human behavior. Numerous adaptive explanations of persistent sadness interfering with daily functioning (hereafter "depression") have been proposed, but most do not explain frequent bidirectional associations between depression and greater immune activation. Here we test several predictions of the host defense hypothesis, which posits that depression is part of a broader coordinated evolved response to infection or tissue injury (i.e. "sickness behavior") that promotes energy conservation and reallocation to facilitate immune activation. In a high pathogen population of lean and relatively egalitarian Bolivian forager-horticulturalists, we test whether depression and its symptoms are associated with greater baseline concentration of immune biomarkers reliably associated with depression in Western populations (i.e. tumor necrosis factor alpha [TNF-α], interleukin-1 beta [IL-1β], interleukin-6 [IL-6], and C-reactive protein [CRP]). We also test whether greater pro-inflammatory cytokine responses to ex vivo antigen stimulation are associated with depression and its symptoms, which is expected if depression facilitates immune activation. These predictions are largely supported in a sample of older adult Tsimane (mean±SD age=53.2±11.0, range=34-85, n=649) after adjusting for potential confounders. Emotional, cognitive and somatic symptoms of depression are each associated with greater immune activation, both at baseline and in response to ex vivo stimulation. The association between depression and greater immune activation is therefore not unique to Western populations. While our findings are not predicted by other adaptive hypotheses of depression, they are not incompatible with those hypotheses and future research is necessary to isolate and test competing predictions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.