Chapter 12 Somatic Symptoms disorders

Question 1

Persistent/extreme preoccupation with and distress over physical symptoms. - preocuppied and phys illness
Exaggerated; may come along with other phys disorders
Client experiences physical symptoms of significant anxiety and life impairment
Associated with increased health care use, functional impairment, provider dissatisfaction, psychiatric co-morbidity, and failed treatment response. - seen in clinics; not in psychiatric unit; presenting with real phys probs; not know why having issues - dealing with somatic disorder that need address
May be exacerbated by comorbidity of other physical disorders.
Factors that can make it difficult to identify somatic symptom disorders.

Answer 1

Somatic symp disorder

Question 2

Individuals with somatic symptom disorders are often seen in medical clinics and not psychiatric settings because the distressing symptoms present as primarily physical in nature. - more outpt basis
Actual diagnosed medical issues and somatic syndrome disorders can be present concurrently, which can make diagnosis difficult. - look at underlying emotional reasons when cannot actually find anything; feel pain and symps talking about but makes diagnosis diff

Answer 2

Factors that can make it difficult to identify somatic symptom disorders.

Question 3

Somatic symptom disorders
Factitious disorders

Answer 3

The significant differences between somatic symptom disorders and factitious disorders. DSM-5

Question 4

General medical conditions affected by stress or psychologic factors/disorders

Answer 4

Somatic symptom disorders

Question 5

Under somatic disorders
Fabrication of symptoms or self-inflicted injury to assume the sick role - under somatic disorders
fabric/exaggerate symp
Munchaesen’s

Answer 5

Factitious disorders

Question 6

Conversion Disorder - DSM-5
Factitious Disorder Imposed on Self
Factitious Disorder Imposed on Another

Answer 6

Clin pic

Question 7

Presents with impaired motor or sensory function complaint - present with phys ailment; truly an issue
Have symp and go through all testing and not have reason
Findings inconsistent with known neurologic conditions
Symptoms are not voluntarily controlled or created - present with symp
Exhibits either la belle indifference (lack of concern) or high distress - concerned/in panic; not concerned about not moving body limb; what underlying reason for phys presentation - hint what dealing with it; lack intense emotion of distress; big cue
Current theories dispute a purely psychologic origin: patients have smaller hippocampal volume
Co-morbidities: childhood abuse, depression, anxiety, personality disorder
Happens quickly and no reason - something psychologically going on others

Answer 7

Conversion Disorder - DSM-5

Question 8

Deliberate symptom fabrication or self-injury without obvious potential reward (attention assumed to be possible motivation—but not clear)
Create prob for self - chronic issue
Cause phys symp
Patient identifies self deceptively as impaired or ill
Single or recurrent episodes
Different from malingering: faking injury for obvious (usually monetary) gain; creating injury for obvious reasons - for attention

Answer 8

Factitious Disorder Imposed on Self

Question 9

Perpetrator/patient is usually parent or caregiver; motivation is attention or nurturing for self at expense of a dependent victim
Make children sick
Like the attention from it
Creates prob for child; what getting from that - sometimes the heroes

Answer 9

Factitious Disorder Imposed on Another

Question 10

Nursing assessment: History and course of past symptoms; current physical and mental status; run through all phys issues; good phys assessment; not seeing anything; hx what going on; red flags - look for secondary gain; good assessment
Assess for secondary gains (benefits derived from symptoms) - what gain by it; extra attention or get out of something
Ability to communicate emotional needs
Dependence on medications (anxiolytics such as benzodiazepines; “rebound anxiety” on withdrawal) - factor

Answer 10

Nursing process for somatic symp disorders

Question 11

Patients with many somatic complaints often become dependent on pain, anxiety, and sleep medications. - symp and HCP prescribe them because presented with them so prescribe them so issue for indiv so dependent so return for them; assessment imp - need identify what going on
Physicians prescribe anxiolytic agents for patients concerned about symptoms.
Patients often return to a physician for prescription renewal and seek treatment from many physicians.
Nurse assessment of the medications used is important.

Answer 11

Dependence on med