Am J Psychiatry 1992; 149:1374-1379
Copyright © 1992 by American Psychiatric Association
Bereavement reactions among homosexual men experiencing multiple losses in the AIDS epidemic
R Neugebauer, JG Rabkin, JB Williams, RH Remien, R Goetz and JM Gorman
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, NY 10032.
OBJECTIVE: The authors examined whether deaths of lovers and close friends
from AIDS increased the frequency of depressive symptoms and depressive
disorder in a group of homosexual men. METHOD: Two hundred seven volunteer
male homosexual subjects were interviewed in New York City in 1988 and
1989. Depressive symptoms were measured with the Hamilton Rating Scale for
Depression, administered by a clinician, and two self-report symptom
checklists. Subjects were evaluated for major depression with the
Structured Clinical Interview for DSM-III-R. Each subject also reported the
number of lovers and close friends who had died of AIDS 1) since the
beginning of the epidemic in 1981 and 2) in the 6 months preceding the
interview. RESULTS: Neither the overall level of depressive symptoms, the
presence of specific symptom clusters, nor the presence of a diagnosed
depressive disorder was related to the number of AIDS deaths a subject
reported in either time frame. In contrast, bereavement reactions specific
to loss, namely, preoccupation with and searching for the deceased, were
more common in subjects with greater numbers of losses. The findings for
depressive symptoms and major depression are not readily explained by
measurement artifact, overrepresentation of asymptomatic subjects among
study volunteers, habituation effects, numbness, or shallowness of
attachments in the subjects. CONCLUSIONS: Changes in normative expectations
regarding AIDS deaths and mobilization against AIDS within the gay
community may account for the lack of association between the number of
losses resulting from AIDS and the presence of depressive symptoms and
depressive disorder.
