Cohen M A
New York Medical College, Metropolitan Hospital Center, New York.
Gen Hosp Psychiatry. 1990 Mar;12(2):98-123. doi: 10.1016/0163-8343(90)90020-d.
The human immunodeficiency virus (HIV) epidemic has created a multidimensional crisis that is challenging the health care system. Individuals with or without risk behaviors have anxieties about acquired immunodeficiency syndrome (AIDS) and need support and counseling. Once symptoms of HIV infection develop, crisis intervention and support need to be integrated into ongoing medical care. A biopsychosocial approach enables persons with AIDS to develop strategies for coping, to improve adherence, and to prevent transmission and suicide. Persons with AIDS are confronted with severe illnesses, neuropsychiatric disorders, discrimination, and death. Each person deserves the best medical and psychologic care available and the services of other disciplines where indicated. Caregivers, anxious about contagion, are devastated by the complexity, severity, and multiplicity of the illnesses that comprise AIDS and the lack of adequate resources to combat the epidemic. AIDS is a paradigm of a medical illness that requires a biopsychosocial approach. Psychiatric sequelae complicate the HIV epidemic, affecting both the uninfected and infected. The psychiatric manifestations of the uninfected include anxiety, phobia, factitious disorder, delusions, and Munchausen's AIDS. Psychiatric disorders associated with HIV infection include organic mental disorders, substance abuse disorder, affective disorders, adjustment disorders, anxiety disorders, and personality disorders. The consultation-liaison (C-L) psychiatrist is in a unique position to clarify and treat the psychiatric complications and to provide leadership for multidisciplinary programs. The biopsychosocial approach enables persons with HIV infection, their loved ones, and caregivers to meet the challenges of the HIV epidemic with compassion, optimism, and dignity.
人类免疫缺陷病毒（HIV）流行引发了一场多层面的危机，对医疗保健系统构成了挑战。无论有无危险行为，个体都对获得性免疫缺陷综合征（AIDS）感到焦虑，需要支持和咨询。一旦出现HIV感染症状，危机干预和支持就需要融入到持续的医疗护理中。生物心理社会方法能使艾滋病患者制定应对策略，提高依从性，预防传播和自杀。艾滋病患者面临着严重疾病、神经精神障碍、歧视和死亡。每个人都应得到现有的最佳医疗和心理护理以及其他相关学科的服务。护理人员因担心传染而备受煎熬，艾滋病所包含的疾病的复杂性、严重性和多样性以及缺乏足够资源来抗击这一流行病，让他们深受打击。艾滋病是一种需要生物心理社会方法的医学疾病范例。精神后遗症使HIV流行情况更加复杂，对未感染者和感染者都会产生影响。未感染者的精神表现包括焦虑、恐惧症、做作性障碍、妄想和孟乔森氏艾滋病。与HIV感染相关的精神障碍包括器质性精神障碍、物质使用障碍、情感障碍、适应障碍、焦虑障碍和人格障碍。会诊联络（C-L）精神科医生在阐明和治疗精神并发症以及为多学科项目提供领导方面具有独特地位。生物心理社会方法能使HIV感染者、他们的亲人以及护理人员以同情、乐观和尊严应对HIV流行带来的挑战。
