The "triple-threat" patient: Psychiatric problems, substance abuse disorders, and HIV

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Individuals with psychiatric disorders are at increased risk of HIV infection, inadequate treatment, and poor treatment outcomes. A recent study that compared patients at an HIV clinic who had received treatment for psychiatric disorders to patients for whom psychopathology had not been assessed or treated found that patients who were receiving treatment had significantly better rates of HIV treatment initiation and adherence, and they also tended to have a lower incidence of mortality. HIV infection and psychiatric disorders have the potential to reinforce and amplify one another: psychiatric disorders increase risk of HIV infection, and HIV infection contributes to depression, demoralization, and substance abuse. The current emphasis on checklist-based psychiatric diagnosis and treatment leads to the lack of recognition of important psychiatric care issues and also contributes to polypharmacy. Psychiatric disorders may be viewed from at least 4 different perspectives: as brain diseases, behavioral disorders, disorders of personality, or disorders of life experience. Disorders of life experience are common in the HIV clinic but are often difficult to recognize or treat using standardized diagnostic checklists. More effective management of psychiatric disorders and substance abuse would improve long-term clinical outcomes in patients with HIV infection.

Original languageEnglish (US)
Pages (from-to)S138-S144
JournalAdvanced Studies in Medicine
Issue number3 A
StatePublished - Mar 1 2006

ASJC Scopus subject areas

  • General Medicine


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