13A somatoform disorders, somatization, conversion disorder, hypochondriasis etiology diagnostic, management

Question 1

Somatic Symptom Disorder DSM5

Answer 1

S- somatic symptoms
O- one or more
M- medically unexplained
E- excessive
A- anxiety about what symptom could mean
T- thinking about symptom
T- time and energy spent related to symptom
I- impairing
C- chronic ( more than 6 m)

Question 2

Somatic Symptom Disorder gender

Answer 2

females&raquo_space; males;

prevalence in the general adult population 5-7%.

Question 3

treatment of somatic symptom disorder

Answer 3

• regularly scheduled visits
• do no harm : dont do unnecessary tests
• CBT
• antidepressants: but may trigger more somatic symptoms

Question 4

Conversion Disorder DSM5

Answer 4

Involves neurologic abnormality such as numbness, weakness, blindness, siezures

symptoms are genuinely experienced

Question 5

conversion disorder treatment

Answer 5

• education about the illness.
• CBT, with or without physical therapy, can be used if education alone is not effective.

Question 6

hypochondriasis: Illness Anxiety Disorder

dsm5

Answer 6

less about medically unexplained symptoms and more about obessional belief that one has medical illness despite all evidence which show no illness

Question 7

hypochondriasis is more similar to which disorder

Answer 7

OCD spectrum disorder
obession with having a medical illness which doesnt exist

Question 8

hypochondriasis gender

Answer 8

Incidence male ≈ female;

average age of onset 20-30 years;

approx. 65% of patients have coexisting major mental
disorder.

Question 10

hypochondriasis treatment

Answer 10

• regularly scheduled visits with a single primary care physician, who should minimize unnecessary medical workups and treatments.
• Comorbid anxiety and depressive disorders should be treated with
  the appropriate pharmacologic and non-pharmacologic means

Question 12

which disorders do patients fake symptoms

Answer 12

• fastitious disorder (obtain internal benefits such empathy, attention)
• malingering disorder (obtain external reward)

Question 13

Factitious Disorder imposed on self

Answer 13

Question 14

Factitious Disorder Imposed on Another (Factitious Disorder by Proxy

Answer 14

Question 15

Factitious Disorder gender

Answer 15

more in females
more common among hospital and health care workers

Question 16

factitious disorder is associated with

Answer 16

Associated with personality disorders.

Many patients have a history of illness and hospitalization, as well as childhood physical or sexual abuse

Question 17

Factitious Disorder treatment

Answer 17

• collect collateral information from medical providers and family, collaborate with primary
  care physician and treatment team to avoid unnecessary procedures.
• Patients may require confrontation in a nonthreatening manner; however, patients who are confronted may leave
  against medical advice and seek hospitalization elsewhere.

Question 18

Malingering def

Answer 18

intentional production of false or grossly exaggerated physical or
psychological symptoms,

motivated by external incentives (2° gain) such as avoiding military duty, avoiding work,
obtaining financial compensation, evading criminal prosecution, or obtaining drugs

Question 19

Malingering gender

Answer 19

(male > female)

generally uncooperative and refuse to accept a good prognosis even after extensive medical evaluation.

Their symptoms improve/cease once their desired objective is obtained (in contrast with
factitious disorder).

Question 20

is malingering considered a mental illness

Answer 20

*Malingering is not considered a mental illness