1. Understanding the psychodynamics of non-adherence to medical treatment in persons with HIV infection
- Author
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Cesar A. Alfonso, Alan Cohen, Debbie Indyk, Rosalind G. Hoffman, Mary Ann Cohen, Nancy Quiñones, and Francisco Ricart
- Subjects
Adult ,Patient Care Team ,Biopsychosocial model ,Child abuse ,Acquired Immunodeficiency Syndrome ,medicine.medical_specialty ,AIDS Dementia Complex ,business.industry ,medicine.disease ,Psychodynamics ,Mental health ,Stress Disorders, Post-Traumatic ,Treatment Refusal ,Psychiatry and Mental health ,Acquired immunodeficiency syndrome (AIDS) ,HIV Seropositivity ,medicine ,Abandonment (emotional) ,Humans ,Dementia ,Female ,Young adult ,Psychiatry ,business - Abstract
We present this medical-psychiatric case discussion to illustrate the psychodynamic aspects of nonadherence in a woman with AIDS. Our patient sustained severe, repeated abandonment and brutal emotional, physical and sexual trauma throughout her early and later childhood and adult life. Her care was considerably complicated by the sequelae of trauma including difficulty with trust and posttraumatic stress disorder. The additional problem of HIV dementia compounded the patient's nonadherence to treatment. We present a multidisciplinary biopsychosocial approach that enabled the patient to engage in both medical and psychiatric care.
- Published
- 2002
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