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Interviews with optimistic and depressed patients from four diagnostic groups were rated by 145 health professionals. Ratings were made on 14 scales that were concerned with patients' feelings, adjustment, likeableness, and prognoses, and with treatment strategies. Discriminant analyses showed significant differences between the reactions to optimistic and depressed patients in all diagnostic groups, but these differences were more extensive for less stigmatized conditions (heart attack, rheumatoid arthritis) than for more stigmatized diagnoses (cancer, paraplegia). The implications of the findings for Scott's (1970) theory of professionals' ideologies and Wright's (1983) notion of the social requirements of cheerfulness and mourning in the disabled are discussed.