INTRODUCTION: Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by eczema, pruritus and cutaneous hyperreactivity to allergic triggers. We and others have reported that psychogenic stress aggravates these symptoms, while viewing humorous films alleviates them. We have also found that many AD patients suffer from erectile dysfunction (ED). ED exhibits multifactorial etiologies, including psychogenic stress and reduction of serum testosterone levels. AIMS: This study assessed the effects of viewing humorous films on ED in patients with AD. MAIN OUTCOME MEASURES: The effects of viewing humorous films on International Index Erectile Function (IIEF) domain (erectile function, orgasmic function, sexual desire, intercourse satisfaction, overall satisfaction) were studied. METHODS: Subjects comprised 36 AD patients with ED and their healthy wives. Randomly assigned 18 patients and their healthy wives first viewed humorous films on three consecutive days (Days 1-3). After 2 weeks, they viewed control nonhumorous weather information films on three consecutive days (Days 1-3). Alternatively, other 18 patients and their wives first viewed control films on three consecutive days, and after 2 weeks they viewed humorous films on three consecutive days. Severity of ED and serum testosterone and estradiol levels were assessed 1 day before viewing (Day -1) and 1-4 days after viewing (Days 4-7). RESULTS: Viewing humorous films significantly improved the IIEF domain in association with increased serum testosterone levels and decreased serum estradiol levels on Day 4, while viewing control films failed to do so. However, this effect was short-term. After 4 days of viewing (Day 7), no improvement in ED or modulation of serum sex hormone levels was observed. CONCLUSIONS: Viewing humorous films improved ED in AD patients in association with increased serum testosterone levels and decreased serum estradiol levels. These results may be useful for the study and treatment of ED.

CONTEXT:For older adults, the damaging effects of aging and stress can impair the ability to learn and sustain memory. Humor, with its associated mirthful laughter, can reduce stress and cortisol, a stress hormone. Chronic release of cortisol can damage hippocampus neurons, leading to impairment of learning and memory.

OBJECTIVES:The primary goal of this study was to determine whether watching a humorous video had an effect on short-term memory in an older population.

DESIGN:The research team designed a randomized, controlled trial.

SETTING:The study took place at Loma Linda University in Loma Linda, California.

PARTICIPANTS:The research team recruited 20 normal, healthy, older adults, 11 males and 9 females.

INTERVENTION:The humor group (n = 10, mean = 69.3± 3.7 y) self-selected 1 of 2 humorous videos--a Red Skelton comedy or a montage of America's Funniest Home Videos--and watched it for 20 min. A control group (n = 10, mean = 68.7 ± 5.5 y) sat calmly for 20 min and were not allowed to read, sleep, or talk on a cell phone.

OUTCOME MEASURES:The Rey Auditory Verbal Learning Test was used to assess short-term memory--learning ability, delayed recall, and visual recognition. Salivary cortisol levels were measured at predetermined times.

RESULTS:Learning ability improved by 38.5% and 24.0% in the humor and control groups, respectively (P = .014). Delayed recall improved by 43.6% and 20.3% in the humor and control groups, respectively (P =.029). Within the humor group, delayed recall (43.6%) was significant compared with learning ability (38.5%) (P = .002). At 3 predetermined time points, significant decreases in salivary cortisol were observed in the humor group (P = .047, P = .046, and P = .062, respectively).

CONCLUSION:The study's findings suggest that humor can have clinical benefits and rehabilitative implications and can be implemented in programs that support whole-person wellness for older adults. Learning ability and delayed recall are important to these individuals for a better quality of life--considering mind, body, spirit, social, and economic aspects. Older adults may have age-associated memory deficiencies. However, medical practitioners now can offer positive, enjoyable, and beneficial humor therapies to improve these deficiencies.

We assessed the impact of humorous movies on psychopathology, anxiety, depression, anger, social functioning, insight, and therapeutic alliance in schizophrenia inpatients. Twenty-nine psychiatric inpatients in open wards participated in the study. The study group viewed humorous and the control group viewed neutral movies daily for 3 months. Participants were assessed before and after viewing movies with the Positive and Negative Symptom Scale, Calgary Depression Scale, the State-Trait Anxiety Inventory, the State-Trait Anger Expression Inventory-2, the Multinomah Community Ability Scale, the Insight and Treatment Attitude Questionnaire, and the Working Alliance Inventory. Reduced levels of psychopathology, anger, anxiety, and depression symptoms and an improvement in social competence were revealed in the study group. No changes were observed in treatment insight or working alliance. Video films are a practical and cost-efficient means of entertainment that seem to have a positive effect on patient morale, mood, and mental status.

BACKGROUND:There have not yet been any published studies on the effects of laughter therapy on radiation-induced dermatitis in breast cancer patients treated with radiotherapy (RT). We assessed the effectiveness of laughter therapy in preventing radiation dermatitis in patients with breast cancer.

METHODS:Thirty-seven patients were prospectively enrolled in this study. Eighteen patients were assigned to the experimental group and the other 19 patients were assigned to the control group. The patients who were assigned to the experimental group received laughter therapy during RT. Laughter therapy was started at the onset of RT and was provided twice a week until completion of RT. The patients who were assigned to the control group only received RT without laughter therapy. The grade of radiation dermatitis was scored by a radiation oncologist who was blinded to subject assignment. The patients' evaluation of pain within the RT field was also assessed.

RESULTS:In the experimental group, radiation dermatitis of grade 3, 2, and 1 developed in five (33.3%), five (33.3%), and five patients (33.3%), respectively. In comparison, in the control group, radiation dermatitis of grade 3, 2, 1, and 0 developed in seven (36.8%), nine (47.4%), two (10.5%), and one patient (5.3%), respectively. The experimental group exhibited a lower incidence of grade 2 or worse radiation dermatitis than the control group (33.3% versus 47.4%). The mean maximal pain scores in the experimental and control group were 2.53 and 3.95, respectively. The experimental group complained of less severe pain than the control group during RT. However, these differences were not statistically significant.

CONCLUSION:The results of this study show that laughter therapy can have a beneficial role in preventing radiation dermatitis in patients with breast cancer. To confirm the results of our study, well-designed randomized studies with large sample sizes are required.

It has become increasingly recognized and more widely acknowledged during the past several decades, that a complex relationship exists between behavior associated with emotion and the human cardiovascular (CV) system. Early studies focused on the interplay between negative emotions and elevated CV risk, an effect that has in large part been attributed to increased adrenergic activity. Thus, a variety of adverse CV effects ranging from sudden cardiac death triggered by natural disasters such as earthquakes to transient myocardial stunning resulting from heightened sympathetic overload have been identified in response to acute emotional distress. In fact, the biologic interplay between emotion and CV health has been greatly enhanced through studies of the vascular endothelium. As the largest organ in humans, the inner blood vessel lining serves as a conduit for the transfer of blood cells, lipids and various nutrients across the lumen to neighboring tissues. Healthy endothelial cells secrete vasoactive chemicals, most notably endothelial-derived relaxing factor or nitric oxide (NO), that effects smooth muscle relaxation and vessel dilation via a cyclic guanosine monophosphate (cGMP) dependent protein kinase signaling pathway. In addition, endothelial derived NO may reduce vascular inflammation by attenuating or inhibiting leukocyte adhesion and subendothelial transmigration as well as decreasing platelet activation via cGMP mediated pathways. Taken together, studying the endothelium provides an exceptional opportunity to advance our understanding of the potentially important interrelationship between emotions and the vasculature. Premised on the identification of physiological and biochemical correlates, the former was demonstrated after intracoronary administration of acetylcholine yielded paradoxical endothelial vasoconstriction in response to mental stress exercises. More recently, the brachial artery reactivity test (BART) has permitted endothelial function to be assessed in a non-invasive manner. In addition to traditional CV risk factors, exposure to negative emotions including mental stress and depression have been associated with reduced endothelial vasoreactivity as measured by BART. Whether mirthful laughter has the opposite effect garnered consideration following the discovery that mu3 opiate receptors were expressed in the vascular endothelium. Because mirthful laughter induces the release of beta-endorphins which in turn have high affinity for mu3 opiate receptors, we hypothesize that such positive emotions lead to the direct release of NO and associated biological consequences. Indeed, our studies have demonstrated opposing effects on endothelial vasoreactivity between those previously established (e.g., mental stress induced by negative visual and/or auditory stimuli) and those induced after mirthful laughter, thereby providing a potential mechanistic link between positive emotions and beneficial effects on the vasculature. This article reviews the relevant physiology and comments on the potentially wider clinical implications in the integration of this process to improve vascular health.

OBJECTIVES:To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment.

DESIGN:Single-blind cluster randomized controlled trial.

SETTING:A total of 35 Sydney nursing homes.

PARTICIPANTS:All eligible residents within geographically defined areas within each nursing home were invited to participate.

INTERVENTION:Professional"ElderClowns"provided 9 to 12 weekly humor therapy sessions, augmented by resident engagement by trained staff"LaughterBosses."Controls received usual care.

MEASUREMENTS:The Behavior Engagement Affect Measure (BEAM) touchpad observational tool was used to capture real-time behavioral data. The tool assesses the duration in seconds of agitation, positive behavior toward others, engagement, and affect (angry, anxious, happy, neutral, sad).

RESULTS:Seventeen nursing homes (189 residents) received the intervention and 18 homes (209 residents) received usual care. Over 26 weeks, in comparison with controls, the humor therapy group decreased in duration of high agitation (effect size = 0.168 and 0.129 at 13 and 26 weeks, respectively) and increased in duration of happiness (effect size = 0.4 and 0.236 at 13 and 26 weeks, respectively).

CONCLUSION:We confirmed that humor therapy decreases agitation and also showed that it increases happiness. Researchers may consider evaluating impacts of nonpharmaceutical interventions on positive outcomes. Computer-assisted observational measures should be considered, particularly for residents with dementia and when the reliability of staff is uncertain.

A number of recent hypotheses have attempted to explain the ultimate evolutionary origins of laughter and humor. However most of these have lacked breadth in their evolutionary frameworks while neglecting the empirical existence of two distinct types of laughter--Duchenne and non-Duchenne--and the implications of this distinction for the evolution of laughter as a signal. Most of these hypotheses have also been proposed in relative isolation of each other and remain disjointed from the relevant empirical literature. Here we attempt to remedy these shortcomings through a synthesis of previous laughter and humor research followed by (i) a reevaluation of this research in light of theory and data from several relevant disciplines, and (ii) the proposal of a synthetic evolutionary framework that takes into account phylogeny and history as well as proximate mechanisms and adaptive significance. We consider laughter to have been a preadaptation that was gradually elaborated and co-opted through both biological and cultural evolution. We hypothesize that Duchenne laughter became fully ritualized in early hominids between 4 and 2 mya as a medium for playful emotional contagion. This mechanism would have coupled the emotions of small hominid groups and promoted resource-building social play during the fleeting periods of safety and satiation that characterized early bipedal life. We further postulate that a generalized class of nonserious social incongruity would have been a reliable indicator of such safe times and thereby came to be a potent distal elicitor of laughter and playful emotion. This class of stimuli had its origins in primate social play and was the foundation for formal human humor. Within this framework, Duchenne laughter and protohumor were well established in the hominid biobehavioral repertoire when more cognitively sophisticated traits evolved in the hominid line between 2 mya and the present. The prior existence of laughter and humor allowed them to be co-opted for numerous novel functions, and it is from this process that non-Duchenne laughter and the "dark side" of laughter emerged. This perspective organizes the diversified forms and functions that characterize laughter and humor today and clarifies when and how laughter and humor evolved during the course of human evolution.

In modern society, fierce competition and socioeconomic interaction stress the quality of life, causing a negative influence on a person's mental health. Laughter is a positive sensation, and seems to be a useful and healthy way to overcome stress. Laughter therapy is a kind of cognitive-behavioral therapies that could make physical, psychological, and social relationships healthy, ultimately improving the quality of life. Laughter therapy, as a non-pharmacological, alternative treatment, has a positive effect on the mental health and the immune system. In addition, laughter therapy does not require specialized preparations, such as suitable facilities and equipment, and it is easily accessible and acceptable. For these reasons, the medical community has taken notice and attempted to include laughter therapy to more traditional therapies. Decreasing stress-making hormones found in the blood, laughter can mitigate the effects of stress. Laughter decreases serum levels of cortisol, epinephrine, growth hormone, and 3,4-dihydrophenylacetic acid (a major dopamine catabolite), indicating a reversal of the stress response. Depression is a disease, where neurotransmitters in the brain, such as norepinephrine, dopamine, and serotonin, are reduced, and there is something wrong in the mood control circuit of the brain. Laughter can alter dopamine and serotonin activity. Furthermore, endorphins secreted by laughter can help when people are uncomfortable or in a depressed mood. Laughter therapy is a noninvasive and non-pharmacological alternative treatment for stress and depression, representative cases that have a negative influence on mental health. In conclusion, laughter therapy is effective and scientifically supported as a single or adjuvant therapy.

OBJECTIVE: Sperms induced IgE production by seminal B cells from patients with atopic eczema via interaction of B cells with galectin-3 on sperms. We studied the effect of viewing a humorous film on IgE production by seminal B cells cultured with sperms. METHODS: Twenty-four male patients with atopic eczema viewed a humorous film (Modern Times, featuring Charlie Chaplin). Just before and immediately after viewing, semen was collected, and seminal B cells and sperms were purified. Seminal B cells were cultured with sperms and IgE production was measured, while expression of galectin-3 on sperms was assessed. RESULTS: After viewing the humorous film, IgE production by B cells cultured with sperms was significantly decreased. Moreover, expression of galectin-3 on sperms was reduced. CONCLUSION: Viewing a humorous film reduced galectin-3 expression on sperms, which in turn decreased IgE production by seminal B cells cultured with sperms. These results indicate that viewing a humorous film may be helpful for the study and treatment of local IgE production and allergy in the reproductive tract.

INTRODUCTION: Patients with atopic dermatitis suffered from night-time wakening, but the exact mechanism of it was not known. Ghrelin was involved in growth hormone secretion, regulation of appetite, anxiety,night-time wakening and stress. METHODS: Thus salivary ghreli levels during the night were measured in 40 healthy children or 40 patients with atopic dermatitis with night-time wakening. Salivary ghrelin levels at 02:00 h were markedly elevated in patients with atopic dermatitis compared to those in healthy children. RESULTS: Neither viewing control non-humorous film nor viewing humorous film had any effect on healthy children. In contrast, viewing humorous film improved night-time wakening and reduced elevation of salivary ghrelin levels in patients with atopic dermatitis, while viewing control film failed to do so. CONCLUSION: Viewing humorous film may be useful in the treatment of night-time wakening in patients with atopic dermatitis.