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Psychiatry > 2: Functional Disorders > Flashcards

2: Functional Disorders Flashcards

1
Q

What are somatoform disorders

A

Group of disorders where individual repeatedly presents to medical care with symptoms, requesting investigations. Is not reassured when investigations are negative or reassurance by doctor there is no physical pathology

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2
Q

What are two somatoform disorders

A
  • Somatisation disorder

- Hypochrondial disorder

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3
Q

Define somatisation disorder

A

Multiple, recurrent and frequently changing symptoms persisting beyond 2-years duration.

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4
Q

If symptoms of somatisation disorder, but is has persisted less than 2-years what is it called

A

Undifferentiated somatoform disorder

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5
Q

What age group is somatisation disorder more common

A

under 40

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6
Q

Which gender is somatisation disorder more common in

A

Female

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7
Q

What are two risk factors for somatisation disorder

A

Parental anxiety towards illness

FH

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8
Q

How does somatisation disorder present clinically

A
  • Complex medical history
  • Often symptoms entail multiple systems (and
    specialities)
  • Patient’s life revolves around illness
  • Discrepancy between subjective (10/10) and objective assessment (eg. patient laughing with others)
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9
Q

What are three differential diagnosis for somatisation disorder

A
  • Hypochondriasis
  • Factitious disorder
  • Malingering
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10
Q

How is hypochondriasis different too somatisation.

A

Hypochondriasis = individual believes they have a specific disorder. Somatisation disorder = multiple systems

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11
Q

What is factitious disorder

A

Individual invents symptoms to occupy sick role

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12
Q

What is malingering

A

Individual invents symptoms of external gain

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13
Q

how should individuals with somatisation disorder be managed

A
  • Avoid over investigation
  • Periodic reviews with same practitioner (to avoid over-attendance)
  • CBT
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14
Q

what is a risk with somatisation disorder

A

Iatrogenic harm due to over investigation

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15
Q

define hypochondriasis

A

preoccupation with possibility of having one or more progressive physical disorders which persist despite medical investigations and reassurance, with subsequent distress and impaired function

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16
Q

which gender is hypochondriasis more common

A

equal

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17
Q

what is a risk factor for hypochondriasis

A
  • Parental or childhood serious illness

- Neglect or emotional abuse

18
Q

how does hypochondriasis present clinically

A
  • Pre-occupation significant serious progressive disorder
  • Rumination
  • Interprets normal bodily functions as signs of serious illness
  • Seeks medical advice but is un-reassured by negative results
19
Q

how should hypochondriasis be managed

A
  • Allow patient to vent anxieties
  • Explain results negative test
  • TCA
  • Behavioural therapy
20
Q

what is dissociative disorder also known as

A

conversion disorder

21
Q

define dissociative disorder

A

loss or disturbance of motor, sensory or cognitive functions that initially thought due to physical or neurological cause and later found to be due to psychological causes

22
Q

what was the initial theory behind dissociative disorders

A

suppression of unacceptable conscious leads to manifestation as physical symptoms

23
Q

what is important to note about dissociative disorders

A

symptoms are not consciously invented by the individual (different to malingering and factitious disorder)

24
Q

what are common features of dissociative disorders

A
  • Paralysis unilateral face or arm
  • Sensory loss
  • Patchy amnesia
  • Aphonia
25
Q

explain paralysis in functional disorder

A

Usually flaccid paralysis.

Individual is unable to consciously move limb, however, synergistic movement does occur

26
Q

what sign is visible in functional disorder

A

Hoover sign

27
Q

what is unique about sensory loss in functional disorders

A

Fits with individual’s anatomical beleifs

28
Q

how are functional disorders usually diagnosed

A

Clinical - inconsistent nature of signs and symptoms

29
Q

how are functional disorders identified

A
  1. Exclude organic diagnosis
  2. Identify positive signs
  3. Supportive psychological cause underlying symptoms
30
Q

explain management of functional disorders

A
  • Frame as positive diagnosis: no serious underlying pathology
  • Discourage use of aids that may reinforce sick role (eg crutch)
31
Q

Define chronic fatigue syndrome

A

presence of disabling fatigue for 4-months affecting physical and mental function more than 50% time, in absence of any organic pathology

32
Q

What time period is required to diagnose chronic fatigue

A

4-months

33
Q

In which gender is chronic fatigue more common

A

Female

34
Q

what is the main symptom of chronic fatigue

A

Disabling fatigue

35
Q

what are other symptoms of chronic fatigue syndrome

A 
Cognitive: impaired short-term memory 
Flu-like illness
Headache
Muscle pain 
Painful lymph node enlargement 
Nausea 
Palpitations
36
Q

what does NICe recommend in chronic fatigue syndrome

A

Screen for organic causes

37
Q

what is used to manage CFS

A
  • Pacing
  • Graded exercise therapy
  • CBT
  • amytryptiline
38
Q

what is pacing

A

organising activities to avoid tiring

39
Q

what is factitious disorder also known as

A

Munchausens

40
Q

what is Muchausen’s disorder

A

Individuals fabricate symptoms and signs and past medical history, with primary intention of gaining medical attention and treatment

Psychiatry (13 decks)

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