Ch 17 Somatic Symptom Disorders Flashcards
Distressing symptoms & an excessive or maladaptive response or associated health concerns w/o significant physical findings & medical diagnosis
Chest pain, fatigue, dizziness, headaches, swelling, back pain, shortness of breath, insomnia, abdominal pain, & numbness
Somatic Symptom Disorder
Somatic Disorders
Results in misinterpretation of physical sensations as evidence of a serious illness
Extreme worry & fear about having a disease, course of illness is chronic & relapsing, symptoms amplify during times of stress
Illness Anxiety D.
(hypochondriasis)
(Somatic Disorders)
Manifests itself as neurological symptoms in the absence of a neurological diagnosis; marked by the presence of deficits in voluntary motor or sensory functions
Paralysis, blindness, movement disorders, gait disorders, numbness, paresthesia, loss of vision/hearing, episodes resembling epilepsy
Conversion Disorder
Somatic Disorders
Consciously pretend to be ill to get emotional needs met & attain the status “patient”
Artificially, deliberately & dramatically fabricate symptoms & self-inflict injury
Factitious disorder
Somatic Disorders
CV Disease Peptic Ulcers Cancer Tension Headaches Essential HTN
medical conditions negatively affected by stress
Burning hands & feet or the sensation of worms in the head or ants under the skin
More common in Africa & southern Asia
Often reported in Greek & Puerto Rican men
Somatization Disorder
PTSD & depression most prevalent symptom for North koreans….
defecting to South Korea
Assess Nature, location, onset, characteristics & duration of symptoms
Explore past Hx of adverse child events
ID symptoms of anxiety, depression & past trauma
Determine quality of life, social support, & coping skills
ID any secondary gain
Explore pt. cognitive style & ability to communicate
Assess current psychosocial & biological needs, including overuse/dependence on meds
Assessment for Somatization Disorders
Reduce Stress
Familiarize self with potential culture misinterpretations
Group therapy
Cognitive-behavioral therapy
Assess for suicidal ideation
Teach pt. techniques to ID & manage anxiety
Develop a relationship with the pt. that includes a mutually agreed upon contract that details expected changes in behavior
Educate pt. about sharing feelings of loss with staff, friends and family members
Assist in the identification of available support systems
Support expression of feelings via the arts such as writing, music & role playing
Assist the pt. in identification of appropriate diversional activities
Encourage the pt. to use positive self-talk such as, “I can do this one step at a time”, “right now I need to stretch & breathe” and “I don’t need to be perfect”
Interventions for Somatization Disorders
Group therapy
CBT
Consistent PCP with regular pt.. visits
Advanced Practice Interventions Somatic symptom Disorder
CBT Group Therapy Insight-oriented therapy stress management psychopharmacological management for comorbids
Advanced Practice Interventions Illness Anxiety disorder
Suggest symptoms will gradually improve Behavioral therapy Insight-oriented therapy Hypnosis Antianxiety drugs
Advanced Practice Interventions Conversion Disorder
Treat psychiatric symptoms
Tailor treatment to include psychological & medical symptoms
Advanced Practice Interventions Psychological factors affecting medical conditions
Confrontation is counterproductive
Emphasis on management over cure
Legal interventions may be necessary (Munchausen)
Advanced Practice Interventions Factitious disorder
