Exam 2: Somatic Symptom Illnesses

Question 1

Psychosomatic

Answer 1

Connection between mind (psyche) and body (soma) in states of health and illness

Question 2

Hysteria

Answer 2

Multiple physical complaints with no organic basis

Question 3

Somatization

Answer 3

Transference of mental experiences, states into body symptoms

Question 4

Somatic symptom illnesses

Answer 4

Three central features:
1. Physical complaints suggest major medical illness but have no demonstrable organic basis
2. Psychological factors and conflicts seem important in initiating, exacerbating, maintaining symptoms
3. Symptoms or magnified health concerns are not under patient’s conscious control

Physical signs and symptoms despite no underlying medical explanation

Rule out medical or organic cause first then prioritize safety

Question 5

Internalization

Answer 5

Internalize what you feel guilty about (leaving work early every day for migraine)

Question 6

Primary gains: Internal motivators

Answer 6

You shouldn’t feel guilty, impacts yourself, disability because you’re sick

Question 7

Secondary gains: External motivators

Answer 7

Family has to do laundry because you can’t go down stairs, not your fault so you shouldn’t feel guilty, affects other people

Question 8

Somatic symptom illness

Answer 8

Multiple physical symptoms (pain, GI, sexual, pseudoneurologic, no organic cause found)

Question 9

Conversion disorder

Answer 9

Unexplained sensory or motor deficits associated with psychological factors, typically involves significant functional impairment

Pseudo-seizures most common

Question 10

La Belle Indifference

Answer 10

Patient seems unconcerned or indifferent to signs and symptoms

Question 11

Pain disorder

Answer 11

Psychological factors influencing onset, severity, exacerbation, maintenance

Pain is the primary physical symptom but it is unrelieved by analgesics

Question 12

Illness anxiety disorder (hypochondriasis)

Answer 12

Disease conviction or disease phobia

Fear that one has a serious disease or will get a serious disease

Question 13

Onset and clinical course

Answer 13

Symptoms usually onset in adolescence or early adulthood

Patients go from one provider or clinic to another, or see multiple providers at once, to obtain relief of symptoms

Question 14

Factitious disorder

Answer 14

Intentional symptoms to gain attention

Conscious decision, willful control of symptoms

Question 15

Munchausen’s syndrome

Answer 15

Imposed upon self

Question 16

Munchausen’s syndrome by proxy

Answer 16

Imposed upon others

May inflict painful, deforming, or life-threatening injury on themselves, their children, or other dependents

Question 17

Malingering

Answer 17

Intentional false or grossly exaggerated symptoms, external incentives (avoid work)

Willful control of symptoms

Question 18

Treatment of somatic symptom illnesses

Answer 18

Symptom management, improvement in quality of life
Anti-depressants for accompanying depression (SSRIs)
Pain clinic referral
Involvement in therapy groups