Chapter 12 Pt 1 Flashcards
what is malingering
CONSCIOUS feigning of symptoms in order to avoid, jail, court, or obtain housing or compensation
SECONDARY GAIN
what is the criteria for somatic symptom disorder
ONE or MORE somatic symptoms (may be predominately pain) that are distressing or result in significant disruption
excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns
lasts at LEAST 6 MONTHS
what are risk factors for somatic symptoms disorder
odler age fewer years of education lower socioeconomic status unemployment history of childhood sexual abuse
what is treatment of somatic symptoms disorder
regularly scheduled casuists with a SINGLE primary care PROVIDER and MINIMIZE UNNECESSARY TESTS
ADDRESS PSYCHOLOGICAL ISSUES SLOWLY
what is criteria for conversion disorder
at least one symptoms of altered voluntary motor or sensory function
incompatibility b/w the symptom and recognized neurological or medical conditions
what are common symptoms of conversion disorder
paralysis weakness blindness mutism sensory complaints (paresthesias) seizures gobs sensation
conversion like symptoms in elderly have higher likely hood of representing what
underlying NEUROLOGICAL deficit
high incidence of cormorbid what in conversion disorder
neurological, depressive, and anxiety disorder
what is tx for conversion disorder
EDCUATION ABOUT ILLNESS
CBT
what is criteria for illness anxiety disorder
PREOCCUPATION with HAVING or ACQUIRING a serious illness
somatic symptoms ARE NOT PRESENT, or if present, mildly intense
high level of anxiety about health
performs excessive health-related behaviors or exhibits maladaptive behaviors
persists for at LEAST 6 MONTHS
what is the ONLY somatic symptoms-related disorder that DOES NOT FAVOR WOMEN
illness anxiety disorders (men and women affected equally)
what is treatment of illness anxiety disorder
REGULARLY SCHEDULED VISITS to ONE PRIMARY care physician
CBT
what factors lead to better prognosis in illness anxiety diroser
fewer somatic symptoms
shorter duration of illness
abscess of childhood physical punishment
what is meant by “Psychological Factors Affecting Other Medical Conditions”
pt with one or more psychological or behavioral factors (distress, coping styles, maladaptive health behaviors) adversely affecting a medical symptom or condition
anxiety worsening asthma
denial of need for treatment of acute chest pain
manipulating insulin to lose weight
absence of external rewards is a prominent feature of what disorder
FACTICIOUS
what is criteria for Factitious disorder
falsification of physical or psychological signs or symptoms, or indication of injury or disease, associated with identified deception
deceptive behavior evident even in absence of obvious external rewards
what is muchhausen syndrome
older name for factitious disorder with predominately PHYSICAL COMPLAINS
what is munchhausen syndrome by proxy
intentionally producing symptoms in someone else who is user one’s care
what are commonly feigned symptoms in factitious isorder
psychiatric- hallucination, depression
medical- fever (heating thermometer), infection, hypoglycemia, abdominal pain, seizures, and hematuria
factitious disorder is seen in higher incidence among what field of workers
hospital and healthcare
many patinets with factitious disorder have a history of what
illness and hospitalization as well as childhood physical or sexual abuse
what is treatment for factitious
collect collateral information from medical treaters and family
collaborate with PCP and treatment team to avoid unnecessary procedures
CONFRONTATION in a NONTHREATENING MANNER
-may leave AMA and seek hospitalization elsewhere
what is malingering
INTENTIONAL reporting of physical or psychological symptoms in order to ACHIEVE PERSONAL GAIN
what are common external motives for malingering
avoiding police
room and board
obtaining narcotics
receiving monetary compensation
malingering is NOT considered what
a MENTAL ILLNESS
patients with malingering usually present how
multiple VAGUE complaints that do not conform to a well known medical condition
long medical history with many hospital stays
what are the distinguishing features of somatic symptom disorders
patients BELEIVE they are ill and do not internally produce or feign symptoms
what are the distinguishing features of factitious disorder
patients intentionally produce symptoms of a psychological or physical illness because of a desire to assume the SICK ROLE, not for external rewards
what are the distinguishing features of malingering
patients intentionally produce or feign symptoms for EXTERNAL REWARDS
