Book: Somatoform Dissociation; Nijenhuuis Flashcards
What is Somatization disorder?
a mental disorder characterized by recurring, multiple, and current, clinically significant complaints about somatic symptoms. In the latest version DSM-V, it was combined with undifferentiated somatoform disorder to become somatic symptom disorder.
What is hysteria in psychiatry?
hysteria - a term formerly used widely in psychiatry. Its meanings have included (1) classical hysteria (now somatization disorder ); (2) hysterical neurosis (now divided into conversion disorder and dissociative disorders ); (3) anxiety hysteria; and (4) hysterical personality (now histrionic personality ).
hysteria is a feature of hysterical disorders in which a patient experiences physical symptoms that have a psychological, rather than an organic, cause; and histrionic personality disorder characterized by excessive emotions, dramatics, and attention-seeking behavior.
Patients with hysterical disorders, such as conversion and somatization disorder experience physical symptoms that have no organic cause. Conversion disorder affects motor and sensory functions, while somatization affects the gastrointestinal, nervous, cardiopulmonary, or reproductive systems. These patients are not “faking” their ailments, as the symptoms are very real to them.
What is hysteria colloquially?
a general state of tension or excitement in a person or a group, characterized by unmanageable fear and temporary loss of control over the emotions.
What are the psychiatric abbreviations?
DSM - Diagnostic and Statistical Manual of Mental Disorders. A psychiatric classificatory system
ICD - International Classification of Diseases. Another classificatory system
Questionnaires
SDQ - Somatoform Dissociation Questionnaire. A self-report questionnaire that aims to measure somatoform dissociative phenomena.
DES - Dissociative Experiences Scale. self report questionnaire that aims to measure psychological dissociation
DIS-Q - Dissociation Questionnaire. self report questionnaire that aims to measure psychological dissociation
What is the definition of dissociative phenomena
a disruption in the normally integrative function of consciousness, memory, identity, and perception of the environment.
They can find expression in disturbances of sensation, movement, speech, vision, hearing, consciousness, memory, and identity
a partial or complete loss of the normal integration between memories of the past, awareness of identity and immediate sensations, and control of bodily movements (ICD-10)
What is somatoform dissociation?
Dissociation may apply to a partial or complete loss of the normal integration of immediate sensation and the control of bodily movements.
What is conversion disorder?
conversion disorder causes patients to suffer from neurological symptoms, such as numbness, blindness, paralysis, or fits without a definable organic cause. It is thought that symptoms arise in response to stressful situations affecting a patient’s mental health.
The ICD-10 classifies conversion disorder as a dissociative disorder[5] while the DSM-IV classifies it as a somatoform disorder.
Typically conversion syndrome begins with some stressor, trauma, or psychological distress that manifests itself as physical symptoms. Usually the physical symptoms of the syndrome affect the senses and movement. For example, someone experiencing conversion syndrome may become temporarily blind due to the stress of the loss of a parent or spouse.
Some of the most typical symptoms include blindness, partial or total paralysis, inability to speak, deafness, numbness, sores, difficulty swallowing, incontinence, balance problems, seizures, tremors, and difficulty walking. These symptoms are attributed to conversion syndrome when a medical explanation for the afflictions cannot be found.[8] Symptoms of conversion syndrome usually occur suddenly, however symptoms are usually relatively brief, with the average duration being 2 weeks up to years in people hospitalized for conversion syndrome-related presentations. While symptoms do not usually last a long time, recurrence is frequently seen.
How does DSM classify conversion disorder?
- One or more symptoms or deficits are present that affect voluntary motor or sensory function suggestive of a neurologic or other general medical condition.
- Psychological factors are judged, in the clinician’s belief, to be associated with the symptom or deficit because conflicts or other stressors precede the initiation or exacerbation of the symptom or deficit. A diagnosis where the stressor precedes the onset of symptoms by up to 15 years is not unusual.
- The symptom or deficit, after appropriate investigation, cannot be explained fully by a general medical condition, the direct effects of a substance, or as a culturally sanctioned behavior or experience.
- The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.
How does ICD classify conversion disorder?
In ICD-10, the dissociative [conversion] disorders class includes 10 disorders that, in addition to specific criteria for each individual disorder, must each meet the following general criteria:
- No evidence of a physical disorder that can explain the symptoms that characterize the disorder (but physical disorders may be present that give rise to other symptoms);
- Convincing associations in time between the symptoms of the disorder and stressful events, problems or needs.[6]
Conversion Disorder
Conversion disorder can present with motor or sensory symptoms including any of the following:
Motor symptoms or deficits:
- Impaired coordination or balance
- Weakness/paralysis of a limb or the entire body (hysterical paralysis or motor conversion disorders)
- Impairment or loss of speech (hysterical aphonia)
- other movement disorders
- Loss of consciousness (fainting)
Sensory symptoms or deficits:
-Impaired vision (hysterical blindness), double vision
-Impaired hearing (deafness)
-Loss or disturbance of touch or pain sensation
Conversion symptoms typically do not conform to known anatomical pathways and physiological mechanisms, but instead follow the individual’s conceptualization of a condition.
What are the 2 categories of hysterical symptoms according to Janet?
Mental Stigmata (aka negative dissociative symptoms)- reflect functional losses
- anesthesia
- losses of sensation
- amnesia
- losses of memory
- loss of motor control
- loss of will (abulia)
- loss character traits (modification of character)
- loss of affects
Mental Accidents (aka positive dissociative symptoms) - reflect intrusions (additional sensations, movements, and perceptions) -intrusions of developed dissociative mental structures into the habitual state of consciousness
