Depression, immunocompetence, and prostaglandins of the E series.

Plasma prostaglandin E1 and E2, and quantitative and qualitative measures of immune function, were determined in depressed patients and healthy controls. Prostaglandin E2 was significantly elevated in the depressed group, and prostaglandin E1 showed a trend in the same direction. Lymphocyte stimulation responses, as measured by phytohemagglutinin, concanavalin A, and pokeweed mitogen, were significantly lower in the depressed group. Helper and suppressor T cell percentages did not significantly differ in the two populations. In the depressed group, prostaglandin E1 showed a significant inverse correlation with concanavalin A, and prostaglandin E2 showed a similar trend. These preliminary data suggest prostaglandins of the E series may be related to abnormalities of cellular immunity previously documented in depression.

Adaptation to chronic illness.

Adaptation to chronic illness is making the best of a bad bargain. The patient who deals successfully with chronic illness is the one who continues to live and function as fully as possible until death is appropriate and inevitable. Good medical care can help, but only if the patient meets the challenges of adaptation--acceptance, the sick role, compromise, and dying. Sometimes the patient can adapt to a new role but the family cannot; denial or nonacceptance on the part of a spouse or family can constitute a tremendous adaptational complication. Ironically, the healthy helpers around the patient, including the physician, may also fail to recognize the magnitude of the challenge of compromise and too easily criticize the patient for meeting it with difficulty or only partially.