Maintenance of hope in HIV-spectrum homosexual men

Article Abstract:

Hope or hopelessness is thought by some to influence psychiatric status, as well as endocrine and immunologic function. For purposes of this study, hope was defined as ''the expectation that something worthwhile lies ahead.'' For terminally ill patients, hope is not necessarily a feature of denial of illness. In addition, some studies have found a correlation between a hopeful state of mind and enhanced physical and mental health. However, there have been conflicting results of investigations of hope as a factor that can alter the course of illness. Most studies have been conducted with cancer patients, but recently, AIDS and AIDS-related complex (ARC) patients have received attention, since loss of hope has been reported as a common feature of these patients. To investigate the impact that social and personal variables may have on the level of hope in patients with human immunodeficiency virus (HIV), the agent that causes AIDS, 124 seropositive and 84 seronegative homosexual men were studied. Most of the men were well-educated, white, and financially successful. Interviews, self-reported rating scales, and neurological and medical examinations were conducted on the subjects. Other specific areas that were focused upon were correlations between illness status, both physical and psychological, and levels of hope in the individual. Results indicated that, on the whole, these men had high levels of hope and relatively low levels of psychiatric and physical symptoms. Levels of hope were generally independent of the subject's HIV status; only slightly lower levels of hope were reported by the HIV-positive men than by the HIV-negative men. A positive correlation was found between hopefulness and perceived social supports. Fewer symptoms of depression were reported in subjects with a strong sense of control over the events in their life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Diseases, HIV patients, Gay men, Hope

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Effects of pill-giving on maintenance of placebo response in patients with chronic mild depression

Article Abstract:

The placebo effect refers to a phenomenon that may be observed in patients who are given an inactive substance rather than a drug, yet experience improvements in symptoms anyway. Many factors are thought to contribute to a placebo response, such as the degree of suggestibility of the patient, the reinforcing behavior of the clinical staff, and the patient's outlook and expectations of treatment. The relationship between the placebo response and pill-taking was assessed among 50 patients diagnosed with mild but chronic depression being treated on an outpatient basis. The subjects were selected from those who showed improvement of symptoms after a 10-day placebo trial; the content of the pill was not divulged to the participants until the study was completed. These 50 subjects were then randomly assigned to continue the placebo protocol or to discontinue all medication for a six-week period. The patients were seen on a bi-weekly basis for this six-week period and all cases of relapse were noted. Demographic characteristics of the subjects were also noted; self-reported ratings, as well as clinical assessments of depression were performed. At the end of the six-week period, half of the patients in each group had relapsed. A total of 58 percent of all patients relapsed after three months. Except for marital status, none of the demographic variables correlated with outcome; married patients tended to maintain the placebo response more frequently than unmarried patients. It is concluded that once a placebo effect is obtained there is no apparent relationship between the maintenance of the effect and the continuance of pill-taking. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Depression, Mental, Depression (Mood disorder), Placebos

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