Functional disorders Flashcards
Definition of functional disorder (2)
Troublesome physical symptoms
not fully explained by a physical disease process or injury
Multiple, recurrent and frequently changing physical symptoms, with a long and complicated history of contact with medical services, for which no organic cause can be found
Somatization
Examples of specific functional disorders (3)
Fibromyalgia and chronic fatigue
IBS
Non-epileptic attack disorder
Core features of chronic somatisation (2)
Multiple physical symptoms
Refusal to accept reassurance or negative results
Poor prognostic indicators in functional disorders (3)
Long symptom duration
Motor symptoms
Personality disorder
Predisposing factors for somatoform disorders (3)
Adverse childhood experiences
Personality- neurotic, anxious
Cognitive styles- catastrophising, external locus of control
Precipitating factors (3)
Major threats to health
Personal losses
Psychiatric illness
Perpetuating factors (3)
Over-investigation
Secondary gains
Wanting to avoid “loss of face”
Examination features which might suggest functional rather than organic cause (3)
Hoovers sign
Inconsistencies in exams which don’t make sense
Non-anatomical signs e.g. sensory loss
What does Hoover’s test look for?
Distinction between organic and functional paraparesis of the hip flexors
Excessive worry about severe physical illness e.g. cancer in the absence of, or presence of mild, symptoms
Hypochondriasis (or health anxiety)
Condition in which a person deliberately acts as if he has a physical disorder in order to gain medical attention
Factitious disorder (previously Munchausen’s syndrome)
Malingering
Feigning illness for secondary gain e.g. welfare payments
How does Hoover’s sign detect non-organic weakness?
In organic weakness, the contralateral hip extends when the patient attempts to flex their hip against resistance. There is lack of contralteral extension in non-organic weakness
What does conversion disorder typically involve?
Loss of sensory/motor function
