This is a study of forty-two patients, aged eighteen to forty-five, who were hospitalized on a general medical service. The major hypothesis is that important changes in object relationships antedate the onset of illness. Fears of separation from an important person occurred before onset of the disease in forty-one of the forty-two patients. Occasionally depressive symptoms accompanied these fears. Actual object loss was found in only five of the patients, but thirty patients suffered threatened and symbolic object losses. Reports and inferences as to affect before the illness showed feelings of helplessness or hopelessness in a large majority of the patients studied. The object loss or onset of depressive symptoms occurred within twenty-four hours before the onset of illness in sixteen patients, and within one week before the onset of illness in thirty-one patients. Ten selected case abstracts are appended and lend credibility to the study.