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Abstract

It is well documented that patient adherence to medical advice and prescription medication is suboptimal. While the reasons for non-compliance are varied and complex, it is essential that they be expounded to facilitate the efficacy of medical interventions. In no other illness is this more pertinent than with the human immunodeficiency virus (HIV). Highly active antiretroviral therapy (HAART) has become the first line of treatment for HIV, but stringent adherence is a prerequisite for therapeutic efficacy. As with other treatments, adherence to HAART is problematic. One factor that may play a significant role is if the patient has a comorbid psychiatric illness. This article provides a theoretical exposition of how a patient with Borderline Personality Disorder (BPD) might suffer innumerable exigencies with adherence as a hypothesised function of the individual properties of his or her illness that is likely to be compounded when the properties interact with one another.

Keywords

adherence borderline personality disorder (BPD)highly active antiretroviral therapy (HAART)human immunodeficiency virus (HIV)non-compliance

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References

Albus

Schmeißer

Salzberger

Fätkenuer

(2005). Preferences regarding medical and psychosocial support in HIV-infected patients. Patient Education and Counselling, 56(1), 16–20

American Psychiatric Association (APA). (2000a). Diagnostic and statistical manual of mental disorders: Text revision (DSM-IV-TR) (4th ed.). Washington, DC: APA

American Psychiatric Association (APA). (2000b). Quick reference to the diagnostic criteria from DSM-IV-TR. Washington, DC: APA

Angelino

A. F.

Treisman

G. J.

(2001). Management of psychiatric disorders in patients infected with human immunodeficiency virus. HIV/AIDS, 33, 847–855

Arntz

(2005). Introduction to special issue: Cognition and emotion in borderline personality disorder. Journal of Behaviour Therapy and Experimental Psychiatry, 36, 167–172

Barlow

D. H.

Durand

V. M.

(2002). Abnormal psychology (3rd ed.). Belmont, CA: Wadsworth

Bateman

Fonagy

(2004). Psychotherapy for borderline personality disorder. Oxford: Oxford University Press

Benazzi

(2006). Borderline personality disorder: Bipolar spectrum relationship. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 30(1), 68–74

Butcher

J. N.

Mineka

Hooley

(2004). Abnormal psychology (12th ed.). Boston, MA: Allyn & Bacon

10.

Chesney

M. A.

Morin

Sherr

(2000). Adherence to HIV combination therapy. Social Science and Medicine, 50(11), 1599–1603

11.

del Rio

(2005). AIDS: The second wave. Archives of Medical Research, 36(6), 682–688

12.

Ekstrand

M. L.

Chesney

M. A.

(2002). Adhering to complex medication regimens. In Chesney

M. A.

Antoni

M. H.

(Eds.), Innovative approaches to health psychology: Prevention and treatment lessons from AIDS (pp. 283–306). Washington, DC: American Psychological Association

13.

Eley

(In press). Addressing the paediatric HIV epidemic: A perspective from the Western Cape Region of South Africa.Transactions of the Royal Society of Tropical Medicine and Hygiene.

14.

Ferradini

Jeannin

Pinoges

Izopet

Odhiambo

Mankhambo

Karungi

Szumilin

Balandine

Fedida

Carried

M. P.

Spire

Ford

Tassie

J-M.

Guerin

P. J.

Brasher

(2006). Scaling up of highly active antiretroviral therapy in a rural district of Malawi: An effectiveness assessment. The Lancet, 367(9519), 1335–1342

15.

Fogarty

Roter

Larson

Burke

Gillespie

Levy

(2002). Patients' adherence to HIV medication regimens: A review of published and abstract reports. Patients Education and Counselling, 46(2), 93–108

16.

Hagiwara

Katsuse

Okubu

Shirai

Itoh

Ishigatsubo

(2000). Two cases of HIV infection accompanied with borderline personality disorder. The Journal of the Japanese Association for Infectious Diseases, 74(12), 1077–1080

17.

Halman

M. H.

Bialer

Worth

J. L.

Rourke

S. B.

(2002). HIV disease/AIDS. In Wise

M. G.

Rundell

J. R.

(Eds.), Textbook of consultation-liaison psychiatry: Psychiatry in the medically ill (pp. 807–852). Washington, DC: American Psychiatric Press

18.

Hamilton

N. G.

(1990). Self and others: Object Relations Theory in practice. Northvale, NJ: Aronson

19.

Harvard mental health letter. (2002). Borderline personality: New recommendations. 18(9). New Haven, CT: Yale University Press

20.

Herpertz

S. C.

(2003). Emotional processing in personality disorder. Current Psychiatry Reports, 5(1), 23–27

21.

HIV/AIDS treatment adherence, health outcomes and cost study group. (2004). The HIV/AIDS treatment adherence, health outcomes and cost study: Conceptual foundations and overview. AIDS Care, 16(Supplement 1), S6–S21

22.

Houston

R. J.

Ceballos

N. A.

Hesselbrock

V. M.

O'Bauer

(2005). Borderline personality disorder features in adolescent girls: P300 evidence of altered brain maturation. Clinical Neuropsychology, 116(6), 1424–1432

23.

Hyman

S. E.

(2002). A new beginning for research on borderline personality disorder. Biological Psychiatry, 51(12), 933–935

24.

Ickovicks

J. R.

Meade

C. S.

(2002). Adherence to HAART among patients with HIV: Breakthroughs and barriers. AIDS Care, 14(3), 309–318

25.

Roberts

Johnston K.

Mann

(2000). Barriers to antiretroviral medication adherence in HIV-infected women. AIDS Care, 12(4), 377–386

26.

Karasz

Dyche

Selwyn

(2003). Physicians' experiences of caring for late-stage HIV patients in the post-HAART era: Challenges and adaptations. Social Science and Medicine, 57(9), 1609–1620

27.

Kernberg

O. F.

(1967). Borderline personality organization. Journal of the American Psychoanalytic Association, 15, 641–685

28.

Kluger

Song

(2003). Masters of denial. Time, 161(3), 84–86

29.

Lieb

Zanarini

M. C.

Schmahl

Linehan

M. M.

Bohus

(2004). Borderline personality disorder. The Lancet, 364(9432), 453–461

30.

Linehan

M. M.

Armstrong

H. E.

Suarez

Allmon

Heard

H. L.

(1991). Cognitive-behavioural treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060–1064

31.

Meel

B. L.

(2005). Ethical issues related to HIV/AIDS: Case reports. Journal of Clinical Forensic Medicine, 12(3), 149–152

32.

Mohan

(2002). Treatments for borderline personality disorder: Integrating evidence into practice. International Review of Psychiatry, 14, 42–51

33.

Mugavero

Hicks

(2004). HIV resistance and the effectiveness of combination antiretroviral treatment. Drug Discovery Today: Therapeutic Strategies, 1(4), 529–535

34.

Nair

Lay

(2001). Personality disorders. In Robertson

Allwood

Gagiano

(Eds.), Textbook of psychiatry for Southern Africa (pp. 249–264). Cape Town: Oxford University Press

35.

Ohshima

(2001). Borderline personality traits in hysterical neurosis. Psychiatry and Clinical Neurosciences, 55, 131–136

36.

Opie

L. H.

(2005). HIV/AIDS in South Africa. The Lancet, 366(9482), 291

37.

Penedo

Gonzalez

Dahn

Antoni

Malow

Costa

Schneiderman

(2003). Personality, quality of life and HAART adherence among men and women living with HIV/AIDS. Journal of Psychosomatic Research, 54(3), 271–278

38.

Remien

R. H.

Rabkin

J. G.

(2002). Managing chronic disease: Individual counselling with medically ill patients. In Chesney

M. A.

Antoni

M. H.

(Eds.), Innovative approaches to health psychology: Prevention and treatment lessons from AIDS (pp. 117–139). Washington, DC: American Psychological Association

39.

Renneberg

Heyn

Gebhard

Bachmann

(2005). Facial expression of emotions in borderline personality disorder and depression. Journal of Behaviour Therapy and Experimental Psychiatry, 36(3), 183–196

40.

Reynolds

N. R.

(2003). The problem of antiretroviral adherence: A self-regulatory model for intervention. AIDS Care, 15(1), 117–124

41.

Ricart

Cohen

Alfonso

Hoffman

Quiñones

Cohen

Indyk

(2002). Understanding the psychodynamics of non-adherence to medical treatment in persons with HIV infection. General Hospital Psychiatry, 24(3), 176–180

42.

Rosenthal

M. Z.

Cheavens

J. S.

Lejuez

C. W.

Lynch

T. R.

(2004). Thought suppression mediates the relationship between negative affect and borderline personality disorder symptoms. Behaviour Research and Therapy, 43(9), 1173–1185

43.

Safren

S. A.

Otto

M. W.

Worth

J. L.

Salomon

Johnson

Mayer

Boswell

(2001). Two strategies to increase adherence to HIV antiretroviral medication: Life-steps and medication monitoring. Behaviour Research and Therapy, 39(10), 1151–1162

44.

Sherr

(2000). Adherence: Sticking to the evidence. AIDS Care, 12(4), 373–375

45.

Skodol

A. E.

Gunderson

J. G.

Pfohl

Widiger

T. A.

Livesley

W. J.

Siever

L. J.

(2002). The borderline diagnosis I: Psychopathology, comorbidity, and personality structure. Biological Psychiatry, 51(12), 936–950

46.

Sperry

(1995). Handbook of diagnosis and treatment of the DSM-IV personality disorders. New York: Brunner/Mazel

47.

Spire

Duran

Souville

Leport

Raffi

Moatti

(2002). Adherence to highly active antiretroviral therapies (HAART) in HIV-infected patients: From a predictive to a dynamic approach. Social Science and Medicine, 54(10), 1481–1496

48.

Stilley

C. S.

Dew

M. A.

Pilkonis

Bender

McNulty

Christensen

McCurry

K. R.

Kormos

R. L.

(2005). Personality characteristics among cardiothoracic transplant recipients. General Hospital Psychiatry, 27(2), 113–118

49.

Tang

Pillay

(2004). Transmission of HIV-1 drug resistance. Journal of Clinical Virology, 30(1), 1–10

50.

The Antiretroviral Therapy in Lower Income Countries (ART-LINC) Collaboration and ART Cohort Collaboration (ART-CC) groups (2006). Mortality of HIV-1 infected patients in the first years of antiretroviral therapy: Comparison between low-income and high-income countries. Lancet, 367, 817–824

51.

Tse

(2001). Review of R. Krawitz & C. Watson, Borderline personality disorder: Foundations for treatment. Australian and New Zealand Journal of Mental Health Nursing, 10, 61

52.

Uldall

K. K.

Palmer

N. B.

Whetten

Mellins

(2004). Adherence in people living with HIV/AIDS, mental illness, and chemical dependency: A review of the literature. AIDS Care, 16(Supplement 1), S71–S96

53.

Ursano

R. J.

Epstein

R. S.

Lazar

S. G.

(2002). Behavioural response to illness. In Wise

M. G.

Rundell

J. R.

(Eds.), Textbook of consultation-liaison psychiatry: Psychiatry in the medically ill (pp. 107–126). Washington, DC: American Psychiatric Press

54.

van der Borght

de Wit

T. F. R.

Janssens

van der Loeff

M. F. S.

Rijckborst

Lange

J. M. A.

(2006). HAART for the HIV-infected employees of large companies in Africa. The Lancet, 368(9533), 547–550

55.

Vieira

Rebocho

Sousa

Azevedo

(2003). HIV infection and adherence to therapy during HIV disease. European Journal of Internal Medicine, 14, S114

56.

Walsh

J. C.

Horne

Dalton

Burgess

A. P.

Gazzard

B. G.

(2001). Reasons for non-adherence to antiretroviral therapy: Patients' perspectives provide evidence for multiple causes. AIDS Care, 13(6), 703–720

57.

Ware

Wyatt

Tugenberg

(2005). Adherence, stereotyping and unequal HIV treatment for active users of illegal drugs. Social Science and Medicine, 61(3), 565–576

58.

Wirth-Cauchon

(2001). Women and borderline personality disorder: Symptoms and stories. New Brunswick, NJ: Rutgers University Press

59.

World Health Organisation (WHO). (2003). Adherence to long-term therapies: Evidence in action. Geneva: WHO

60.

Wright

M. T.

(2000). The old problem of adherence: Research on treatment adherence and its relevance for HIV/AIDS. AIDS Care, 12(6), 703–710

61.

Yates

W. R.

(2002). Epidemiology of psychiatric disorders in medically ill patients. In Wise

M. G.

Rundell

J. R.

(Eds.), Textbook of consultation-liaison psychiatry: Psychiatry in the medically ill (pp. 237–256). Washington, DC: American Psychiatric Press

Exploring the Interaction between Comorbid Psychiatric and Medical Diagnoses: The Potential Impact of Borderline Personality Disorder on Adherence to Highly Active Antiretroviral Therapy (HAART)

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