Dissociative/ Somatic Flashcards
When do dissociative events most often occur?
following significant trauma, esp in childhood
What distinguishes dissociative disorders from other neurocognitive disorders?
-procedural memory remains intact
What are common comorbidities assc with dissociative disorders?
- MDD
- PDD/dysthymia
- increased risk for suicide
How common are dissociative disorders?
-6-7% more common in women
Treatment for dissociative disorders?
- removal from traumatic situation
- psychotherapy
What is dissociative fugue now a subtype of?
-dissociative amnesia with dissociative fugue
Contrast depersonalization and derealization
- depersonalization: experiences of detachment from ones body (dejavu)
- derealiztion-detachment from ones surroundings
How common is depersonalization/derealization disorder?
-2%; equal in both sexes; MC age 16
Disorders commonly comorbid with depersonalization/derealization?
- anxiety
- MDD
Treatment for depersonalization/derealization disorder
- CBT
- psychodynamic therapy
- hypnotherapy
Dissociative Identity Disorder is aka?
-multiple personalities disorder
Comorbidities assc with DID
- MDD
- PTSD
- suicide
- eating disorders
- borderline personality disorder
- substance use
How common is suicide in DID?
Better than (70%) commit suicide!
What sex more commonly experiences DID?
women
Treatment for DID
psychotherapy
SSRIs for comorbid MDD,PTSD
-Prazosin for nightmares
-Naloxone to prevent self mutilation
What do you call a dissociative disorder with no name that does cause distress?
-Other specified dissociative disorder
Conversion d/o is aka?
Functional neurological symptom disorder
this helps you remember what conversion disorder IS
How common is somatic symptom disorder?
5-7% population
Criteria for somatic symptom disorder?
- one or more somatic complaints
- significant distress
- at least 6 months
How to handle somatic symptom disorder
-regularly scheduled visits with primary care providers who minimize unnecessary medical testing
Contrast somatic symptom disorder with conversion disorder
- somatic symptom= patient is severely distressed
- conversion disorder= patient has SUDDEN onset of NEURO complaint that they are often unconcerned about (blindness, paralysis, anesthesia)
What population with conversion disorder is most likely to have a true underlying neuro deficit?
-elderly
MC population w/ conversion d/o
- women, teens-early adulthood
- comorbid neuro, depressive, anxiety disorders
Contrast treatment for somatic symptom and conversion disorder:
- conversion: provide EDUCATION about the illness + CBT +/- PT
- somatic symptom: patients more distressed, less likely to accept psych treatment, mainly try to minimize testing
Illness Anxiety D/O criteria:
- 6 months
- excessive health related behaviors
- preoccupation with having/ acquiring a serious illness
Illness Anxiety Disorder:
-sex + age
- men= women
- 20-30
Treatment for Illness Anxiety
- CBT
- SSRIs for comorbid depression/ anxiety
Contrast facticious disorder and malingering
both= conciuous creation of symptoms malingering= for external gain facticious= not for gain
Facticious D/O is aka?
-Munchhausen (primarily physical complaints)
What type of illness is malingering?
ITS NOT!
not considered a psychiatric illness
Sex in which malingering is more common
men
