Integrating evidence-based practices and the recovery model.

Consumer advocacy has emerged as an important factor in mental health policy during the past few decades. Winning consumer support for evidence-based practices requires recognition that consumers' desires and needs for various types of treatments and services differ significantly. The authors suggest that the degree of support for evidence-based practices by consumer advocates depends largely on the degree of disability of the persons for whom they are advocating. Advocates such as members of the National Alliance for the Mentally Ill, who focus on the needs of the most seriously disabled consumers, are most likely to be highly supportive of research that is grounded in evidence-based practices. On the other hand, advocates who focus more on the needs of consumers who are further along their road to recovery are more likely to be attracted to the recovery model. Garnering the support of this latter group entails ensuring that consumers, as they recover, are given increasing autonomy and greater input about the types of treatments and services they receive. The authors suggest ways to integrate evidence-based practices with the recovery model and then suggest a hybrid theory that maximizes the virtues and minimizes the weaknesses of each model.

HIV infection presenting as psychosis: a critique.

A review of the literature on HIV and psychiatry thus far has revealed 13 cases of HIV infection presenting as psychosis. We argue that these cases could in fact represent either coincidental schizophrenia or bipolar disorder and HIV infection or HIV-related organic hallucinosis, delusional or affective syndromes with or without associated dementia (AIDS-dementia complex). The use of the term psychosis in describing AIDS-related behavioral syndromes is misleading, and should be replaced when possible by specific DSM-III-R categories.