Exam 2: Somatic Symptom Illnesses Flashcards
Psychosomatic
Connection between mind (psyche) and body (soma) in states of health and illness
Hysteria
Multiple physical complaints with no organic basis
Somatization
Transference of mental experiences, states into body symptoms
Somatic symptom illnesses
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
Internalization
Internalize what you feel guilty about (leaving work early every day for migraine)
Primary gains: Internal motivators
You shouldn’t feel guilty, impacts yourself, disability because you’re sick
Secondary gains: External motivators
Family has to do laundry because you can’t go down stairs, not your fault so you shouldn’t feel guilty, affects other people
Somatic symptom illness
Multiple physical symptoms (pain, GI, sexual, pseudoneurologic, no organic cause found)
Conversion disorder
Unexplained sensory or motor deficits associated with psychological factors, typically involves significant functional impairment
Pseudo-seizures most common
La Belle Indifference
Patient seems unconcerned or indifferent to signs and symptoms
Pain disorder
Psychological factors influencing onset, severity, exacerbation, maintenance
Pain is the primary physical symptom but it is unrelieved by analgesics
Illness anxiety disorder (hypochondriasis)
Disease conviction or disease phobia
Fear that one has a serious disease or will get a serious disease
Onset and clinical course
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
Factitious disorder
Intentional symptoms to gain attention
Conscious decision, willful control of symptoms
Munchausen’s syndrome
Imposed upon self
Munchausen’s syndrome by proxy
Imposed upon others
May inflict painful, deforming, or life-threatening injury on themselves, their children, or other dependents
Malingering
Intentional false or grossly exaggerated symptoms, external incentives (avoid work)
Willful control of symptoms
Treatment of somatic symptom illnesses
Symptom management, improvement in quality of life
Anti-depressants for accompanying depression (SSRIs)
Pain clinic referral
Involvement in therapy groups
