Effects of Brief Mood-Improving Interventions on Immunity: A Systematic Review and Meta-Analysis

Objective Positive mood has been associated with enhanced immune function. Interventions that improve mood could therefore provide a mechanism for optimizing immune-related health outcomes. Brief interventions that improve mood, also known as mood inductions, potentially offer a pragmatic approach to enhancing immune function for finite periods where this would be beneficial to health (e.g., in advance of vaccination or surgery). This review sought to systematically examine the evidence regarding the effects of brief, single-session positive mood interventions on immunity. Methods Systematic searches of electronic databases were performed from earliest records to July 25, 2018. We identified 42 interventions suitable for inclusion, 6 of which were tested in multiple subpopulations. Random-effects meta-analyses were performed for pre-post experimental group immune outcomes measured in at least five intervention studies. Results Although interventions were heterogeneous, 81% resulted in a statistically significant change in at least one immune parameter after the positive mood intervention for one or more of the subpopulations examined. However, studies were, in general, of low-to-moderate quality with small sample sizes (median n = 32) and did not examine the persistence or clinical relevance of the immune changes observed. Random-effects meta-analyses showed a significant medium-sized effect of interventions on increasing secretory IgA concentration (g = 0.65), a small but statistically significant effect for increased Interleukin-6 production (g = 0.12), and nonsignificant effects on natural killer cell activity (g = 0.15). Conclusions The current literature suggests that improvements in mood resulting from brief interventions can influence some immune parameters in ways indicative of enhanced immune function. However, there is a need for higher-quality research in this area that focuses on clinically relevant immune outcomes and mechanisms.