In most, if not all, chronic illnesses, the patient is a participant in medical management. Attitudes and behaviors during treatment can influence medical outcome in important ways that are becoming increasingly understood. This case history illustrates how a personal style may have contributed to the worst possible outcome, death, in an illness that is usually not fatal. There is a need to unravel the complex interplay between the psychological and medical factors contributing to such extremes in medical treatment failure in order to permit timely and appropriate intervention.
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Dirks et al. (1982) studied this question.
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