The impact of stress on the pathogenesis and course of selected chronic diseases-A review of the literature

Research objective: To analyze the impact of psychological stress on the pathogenesis, course, and exacerbation of selected autoimmune and neurodegenerative diseases, such as rheumatoid arthritis, psoriasis, systemic lupus erythematosus, Hashimoto’s thyroiditis, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, irritable bowel syndrome, and peptic ulcers. Methodology: A comprehensive literature review was performed using databases including PubMed and Google Scholar. The analysis focused on original articles, meta-analyses, and recent review papers published between 2010 and 2025. Search terms included: stress, autoimmune disease, neurodegeneration, inflammation, HPA axis, psychoneuroimmunology, and specific disease names. Main conclusions: Stress contributes to the onset and progression of various diseases by disrupting the hypothalamic-pituitary-adrenal (HPA) axis, altering cytokine profiles, and impairing immune regulation. Common mechanisms across reviewed diseases include increased levels of pro-inflammatory cytokines, reduced cortisol regulation, and disrupted neuroendocrine signaling. These findings demonstrate a consistent association between chronic psychological stress and increased disease severity. Application of the study: Insights from this review may support the integration of psychological assessments and stress management into treatment plans for patients with autoimmune and neurodegenerative disorders. Incorporating mental health care into standard medical practice could enhance overall treatment effectiveness and improve patient outcomes. Originality/Novelty of the study: This study consolidates current evidence on the role of stress across a broad spectrum of both autoimmune and neurodegenerative diseases, emphasizing shared biological mechanisms and advocating for multidisciplinary approaches in clinical management.