Functional Disorders Flashcards
Describe a functional disorder.
Troublesome physical symptoms which after investigation are not fully explained by a physical disease process or injury
The symptoms are real and not imagined.
Consequently, it is likely that brain activity involved in producing the symptoms is triggered by emotional change
Symptoms where one cannot easily associate the symptoms with a classically identifiable organic disease
List common symptoms of functional disorders.
- Pain
- Altered sensation
- Dizziness
- Movement disorders
- Weakness
- Seizures
- Cognitive symptoms
Symptoms like fatigue are the patients ___________ experiences
SUBJECTIVE
Neurology functional somatic symptoms
Functional weakness, non-epileptic attacks, hemisensory symptoms
GI functional somatic symptoms
IBS, non-ulcer dyspepsia, chronic abdominal pain
Gynaecology functional somatic symptoms
Chronic pelvic pain, premenstrual syndrome
ENT functional somatic symptoms
Functional dysphonia, globus pharynges
Cardiology functional somatic symptoms
Atypical chest pain, unexplained palpitations
Rheumatology functional somatic symptoms
Fibromyalgia
Infectious disease functional somatic symptoms
(post-viral) chronic fatigue syndrome
Immunology/allergy functional somatic symptoms
Multiple chemical sensitivity syndrome
What is dissociative disorder?
Is how the symptoms are described in the Internal Classification of Disease
Name 3 main categories of dissociative disorder and explain each of these.
Dissociation – detachment from reality
Depersonalization – a feeling that your body doesn’t quite belong to you or is disconnected from you
Derealization- a feeling that you are disconnected from the world around you or ‘spaced out’
What should always be asked about when taking a history from someone with a suspected functional disorder?
Ask about disability
Ask about dissociation
Ask about other medical experiences
Illness beliefs?
Past medical history – early age hysterectomy, appendicectomy,
Previous functional symptoms
Ask about psychiatric history and mood symptoms
________ ____ is a predictor, evidence of affective disorders increases risk of functional symptoms
Childhood abuse
What type of findings during examination are typical for a functional disorder?
Inconsistent i.e none
_________ ____ is often a sign of a functional disorder
Uneconomic gait
What is hoover’s sign?
It is a maneuver aimed to separate organic from non-organic paresis of the leg
Basically used when a patient complains of ‘unilateral leg weakness’
Explain how hoovers sign is looked for.
Put hand under the thigh of the ‘weak’ leg, ask the patient to lift the opposite leg and the muscles of the weak leg WILL contract if it is a non-organic paresis
- Lay pt on bed
- Put hand under heal of weak leg and ask pt to push down on your hand
- The pt won’t push your hand down because hand is ‘weak’
- Ask pt to raise normal leg and use other hand to push against - resist their movement
- Heal of affected leg will push down on your hand
Outline the 5 steps of formulation.
Normalization – normal, common and seen before
Validation – symptoms are genuine and you are not imaging it
Reversibility – may people make good progress, it can be treated
Blame – it is not your fault you have these symptoms
But – you need to put some effort into getting better
Outline the treatment of functional disorders.
Formulation Treat the treatable CBT Tricyclic antidepressants Breathing retaining – panic disorders/hyperventilation
