BehavioralSciences8-28

Question 1

Diagnosis:

Your patient is a female with a history of a signficant life stress. She presents with neurological symptoms that cannot be explained by any known pathophysiology.

Answer 1

Conversion disorder

Symptoms must manifests unconsciously. Patient may be aware, but sometimes indifferent about the symptoms.

Question 2

Diagnosis:

Your patient presents with a numerous physical compliants that began during his 20s. These ailments have severely impacted his social and ocupational functioning. However, no physical explanation can be found.

Answer 2

Somatization disorder

Question 3

Schizoaffective disorder vs. Schizophrenia vs. MDD/BP with psychotic feat.

Psychotic episodes occur exclusively during mood episodes

Answer 3

Major Depressive Disorder or Bipolar Disorder with psychotic features

Question 4

Schizoaffective disorder vs. Schizophrenia vs. MDD/BP with psychotic feat.

Mood symptoms absent, or present for only brief periods

Answer 4

Schizophrenia

Question 5

Schizoaffective disorder vs. Schizophrenia vs. MDD/BP with psychotic feat.

Mood symptoms present for the majority of the illness; some psychotic episodes concurrent with depressive or manic symptoms

Answer 5

Schizoaffective disorder

Question 6

What are the requirements necessary to diagnose somatization disorder?

Answer 6

1. Symptoms manifest before the age of 30.
2. Patient must have 4 pain symptoms
3. Patient must have 2 GI symptoms
4. Patient must have 1 sexual symptom.
5. Patient must have 1 pseudoneurologic symptom.

*Somatization disorder is really rare.

Question 7

Acute stress disorder and post-traumatic stress disorder are both characterized by the same symptoms: recurrent nightmares & flashbacks, potential memory loss and startled response. How can the two be differentiated clinically?

Answer 7

Acute stress disorder DOES NOT last for longer than four weeks. PTSD last longer than four weeks.

Question 8

What is the best way to manage somatic symptom disorder?

Answer 8

Regularly scheduled visits that focus on functional improvement.

Do not utilize unnecessary diagnostic testing or specialist referrals.

Question 9

What is the most important factor in differentiating schizoaffective disorder from bipolar disorder/major depression with psychotic features?

Answer 9

The temporal relationship of the psychotic symptoms to the mood symptoms.

MDD/BP + psy= NO psychotic symptoms when the patient’s mood is euthymic
Schizoaffective= Psychosis can occur during mood episodes, or alone.

Question 10

What term describes the replacement of an unpleasant thought or desire with an emphasis on its opposite?

Answer 10

Reaction formation