Functional Disorders

Question 1

How can you distinguish between Medically Unexplained Symptoms?

Answer 1

Somatisation = Symptoms.
HypoChonDriac = Cancer or Disease.
Conversion = Not Chronic; Associated with Stress, typically involving loss of motor or sensory function.

Question 2

What is Hoover’s Sign?

Answer 2

A quick and useful clinical tool to differentiate organic from non-organic leg paresis. In non-organic paresis, pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension. Hoover’s Sign supports a Conversion Disorder.

Question 3

What is Malingering?

Answer 3

Symptoms are feigned in order to get something other than medical treatment e.g. compensation, avoiding prison.

Question 4

What is Factitious Disorder (Munchausen’s)?

Answer 4

Symptoms are feigned to receive medical attention; also a psychiatric disorder.

Question 5

Management of Medically Unexplained Symptoms (3).

Answer 5

1. Take all somatic concerns seriously (but avoid duplication and over-investigation).
2. Treat co-existing anxiety/depression.
3. Anti-Depressants, CBT, reassurance and explanations.

Question 6

What is Somatoform Disorder?

Answer 6

Repeated presentation with medically unexplained symptoms, affecting multiple organ symptoms (1st before 40) and chronic.

Question 7

Types of Medically Unexplained Symptoms Disorders (2).

Answer 7

1. Main feature is concern about having disease (hypochondriasis) or deformity (dysmorphobia).
2. Main feature is concern about somatic symptoms (Somatoform Disorder).

Question 8

Clinical Features of Dissociative Disorders (6).

Answer 8

1. Dissociative Amnesia..
2. Dissociative Fugue (New location = New you).
3. Derealisation (World is Unreal).
4. Depersonalisation (Looking at You From 3rd Person).
5. Identity Alteration.
6. Identity Confusion (Difficulty Defining Yourself).