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IMMUNE SYSTEMS OF BREAST CANCER PATIENTS
419
analyzed data at baseline and at the end of the training. The psycho-
logical results of the Hidderley and Holt study indicated a statistically
significant difference in the mean reduction of anxiety (
p
< .0027) and
depression (
p
< .0001) as measured on the Hospital Anxiety and
Depression Scale (HADS) for women receiving autogenic training ver-
sus those who did not. Thus, both studies demonstrated that hypnosis
improves psychological well-being at the end of training.
Regarding the effect of hypnosis on the immune system, the Bakke
et al. (2002) study showed a statistically significant 15.8% increase in
the absolute number of NK cells (
p
< .03) at the end of the psychologi-
cal intervention, but the elevation was not maintained at the 3-month
follow-up when NK cells only showed a 4.5% increase above baseline.
This investigation also found no significant difference in NK cytotoxic-
ity after hypnotic therapy, which may be because the assay lacked sen-
sitivity or because an increase in NK activity requires cellular
activation, which may not have happened. Linear regression analysis
of the change in percentage of NK cells and subscales of the POMS
indicated that the degree of mood improvement related to an increase
in NK cells, thus reinforcing the psychosomatic connection. However,
the effect of the mind on the body as induced by hypnosis was only
temporary and did not last after treatment (Bakke et al., 2002).
The immunological results of the Hidderley and Holt (2004) study
showed no statistically significant difference between the control and
experimental groups in the elevation of CD4
+
, CD8
+
, B cells, NK cells,
neutrophils, and monocytes after hypnosis treatment. However,
within the group receiving autogenic training, only those with the abil-
ity for vivid imagery showed statistically significant increases in CD8
+
and NK cells. Vivid imagery, as defined by Hidderley and Holt, refers
to a meditative rather than relaxed state during hypnosis, and this dis-
tinction in participants was observed by researchers during autogenic
training classes (Hidderley and Holt). The ability of patients to affect
the quality of their meditative experience and thus its effects on their
immune system reflects the importance of considering patient hypno-
tizability when assessing outcomes. As such, it would have been more
objective for the trial to administer a hypnotic susceptibility test to its
participants and stratify results based on hypnotizability scores so that
findings can be extrapolated to other patients with similar levels of
hypnotizability.
R
ECOMMENDATION
FOR
H
YPNOSIS AS
A
DJUVANT
T
HERAPY
IN
B
REAST
C
ANCER
T
REATMENT
The results of the Bakke et al. (2002) and Hidderley and Holt (2004)
trials demonstrate that NK and CD8
+
cell levels can increase at the end
of a 2-month hypnosis treatment in women diagnosed with early stage
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