Introduction

Cell and tissue changes are known to be part of a non-specific response to stressful stimuli. Stressful physical stimuli in rodents increased their susceptibility to infection. These findings implied modification of the immune response, and were attributed to the effects of adrenal corticosteroids. Recent work extending these studies to other species has implicated the action of other hormones, possibly mediated via lymphocyte receptors.

The experiments in the NASA Skylab Programme, which demonstrated depression of lymphocyte transformation and rosette formation on the day of splashdown, appear to be the only prospective studies of the effects of stress on the immune system of healthy people. Retrospective investigations of bereavement and other severely stressful situations have been claimed to show an association between stress and many diseases, including diabetes mellitus, coronary-artery disease, ulcerative colitis, rheumatoid arthritis, lupus erythematosus, and schizophrenia. Claims for an increased mortality after conjugal bereavement are controversial. Bereavement is a life event resulting in great distress or the need for considerable adaptation.7 We determined prospectively the behavioural, endocrinological, and immunological consequences of bereavement.

Methods

Subjects.—Arrangements were made in our group of hospitals for one of us (R. B.) to provide a counselling service for the surviving spouses of patients either fatally injured or who had died from illness. Twenty-six people between the ages of 20 and 65 years9 were interviewed for the study.