Dissociative, Obsessive, and Somatic Disorders

Question 1

dissociation

Answer 1

loss or impaired sense of self

temporary altération in consciousness, memory, personality, behavior or motor function

Question 2

dissociative identity disorder

Answer 2

presence of >2 distinctive identities or states of personalities that take control of behavior

symptoms of disruption may be self reported or observed by others

Question 3

dissociative identity disorder

associated with?

Answer 3

MC in women
hx of sexual abuse
also PTSD

Question 4

depersonalization disorder

Answer 4

persistent feelings of detachment or estrangement from oneself or surrounding environment

during these experiences, reality testing is intact and they symptoms cause distress

Question 5

dissociative amnesia

Answer 5

inability to recall personal/autobiographical information

MC secondary to sexual abuse, stress or trauma

Question 6

dissociative fugue

Answer 6

abrupt change in geographic location with loss of identity or inability to recall the past

Question 7

management of dissociative disorders

Answer 7

psychotherapy

Question 8

obsessive compulsive disorder (OCD)

Answer 8

anxiety disorder with combo of thoughts/obsessions + behaviors/compulsions

Question 9

mean age of onset OCD? gender?

Answer 9

typically in 20s

men = women

Question 10

obsessions

Answer 10

recurrent or persistent thoughts/images

inappropriate, intrusive and unwanted

Question 11

specifiers of obsessions

Answer 11

1. good/fair insight
2. poor insight
3. absent insight/delusional beliefs

Question 12

good/fair insight

Answer 12

recognizes OCD beliefs are not true or may not be true

Question 13

poor insight

Answer 13

thicks OCD beliefs are probably true

Question 14

absent insight/delusional beliefs

Answer 14

completely convinced that the OCD beliefs are true

Question 15

compulsions

Answer 15

repetitive behaviors the person feels driven to perform to reduce/prevent stress

compulsions interfere with Time consuming

Question 16

4 major patterns of OCD

Answer 16

1. contamination (compulsion may include cleaning or hand washing)
2. pathologic doubt (forgetting to unplug iron)
3. symmetry/precision (must arrange objects with precision)
4. intrusive obsessive thoughts

Question 17

management of OCD

Answer 17

1. SSRIS (esp. fluoxetine, sertraline, paroxetine)

2. CBT

Question 18

body dysmorphic disorder

Answer 18

excessive preoccupation that >1 body part is deformed or over exaggeration of minor flaw

causes them to be ashamed or feel self conscious = functional impairment

Question 19

management of body dysmorphic disorder

Answer 19

1. antidepressant

2. psychotherapy

Question 20

somatic symptom disorder

Answer 20

chronic condition where patient has physical symptoms involving >1 body part but NO PHYSICAL cause

Question 21

epidemiology of somatic symptom disorder

Answer 21

MC in women, <30

patients previously diagnosed with hypochondriasis

Question 22

criteria of somatic symptom

Answer 22

one or more vague somatic symptoms that are distressing or causing disruption

> 2 are high likelihood of disorder

“Symptoms Described as Body Laments & Ailments Void a Physical cause”

Question 23

symptom of somatic symptom disorder

Answer 23

SOB 
Dysmenorrhea 
burning in sexual organ 
lump in throat 
amnesia 
vomiting 
painful extremes

Question 24

specifiers of somatic symptom disorder

Answer 24

with predominant pain

• disproportionate and persistent thoughts about seriousness of symptoms
  0 high anxiety level about symptoms or health
• excessive time and energy devoted to symptoms of health concerns