Background: Converging and accumulating evidence for the cross-communication among the nervous, immune, and endocrine systems, a field of study known as psychoneuroimmunology, implicates immunological dysfunction as a shared and common mechanism of both mental and physical illness. For example, psychiatric disorders like schizophrenia, bipolar disorder, major depression, and anxiety disorders have higher prevalence rates across a spectrum of autoimmune conditions compared to the general population. Additionally, subclinical immunological abnormalities are observed in a variety of psychiatric conditions, with chronic inflammation most extensively studied in the pathophysiology of depression. These observations blur the historical distinctions between mental and physical illness, yet clinical practice remains fragmented and primarily focused on differentially treating individual symptoms. Proposed thesis: Therapeutically targeting inflammation offers translational opportunities for integrating mental and physical healthcare, a key niche of the interdisciplinary field of health psychology. Conclusion: Utilizing a psychoneuroimmunological lens, health psychologists and clinicians can reconceptualize healthcare through integrative treatment approaches and advocacy for comprehensive policy-level reform at both the individual-level of care as well as community-wide prevention approaches. K E Y W O R D S health psychology, immune health, mental health, psychoneuroimmunology Mental and physical disorders are often conceptualized and treated as distinct diagnoses with unique etiologies, stemming from the mindbody dualism that underlies much of modern medical biology. 1 The emergence of psychoneuroimmunology, or study of the crosscommunication between the nervous, immune, and endocrine systems, is increasingly blurring the historical distinctions between mental and physical illness as converging and accumulating evidence suggests immune dysfunction and systemic inflammation are commonly observed across many psychiatric conditions. 2-4 Despite this growing body of scientific knowledge, clinical practice remains fragmented and primarily focused on differentially treating disparate symptoms. Psychoneuroimmunology provides a framework for integrating mental and physical healthcare, a key niche of the growing interdisciplinary field of health psychology. This paper describes some of the existing literature documenting the overlap between immune function and mental health and suggests potential clinical implications of a psychoneuroimmunological lens for both individual-level of care as well as community-wide approaches.

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Trait conscientiousness is associated with longer healthspan and lifespan, yet also with suicidal behavior in the second half of life. It remains unclear whether conscientiousness constitutes a vulnerability factor for suicide, particularly in the context of declining health. This cross-sectional study comprised 313 depressed adults aged ≥40 years (mean=62.1), with (n=128) and without (n=185) suicide attempt history. Single-predictor and covariate-adjusted regression models tested the main effect of conscientiousness, and its moderating effects on three health factors relevant to aging: depression severity, cognitive functioning, and the presence of severe physical illness. Outcomes included presence of current suicidal ideation, presence of lifetime suicidal behavior, ideation severity in participants with current ideation (n=227), and suicidal intent severity at the most medically serious attempt in participants with past suicidal behavior (n=128). Conscientiousness mitigated the effect of severe physical illness on the presence of current ideation, and was significantly associated with higher severity of suicidal ideation and intent. These findings were robust to age, gender, depression severity, cognitive functioning, and the presence of severe physical illness. Whereas conscientiousness may help maintain control over certain stressors in the second half of life such as chronic disabling illness, it may exacerbate meticulous contemplation in suicidal individuals.

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