Functional Disorders Flashcards
what are funcitonal symptoms?
symptoms where one cannot easily associate the symptoms with a classically identifiable organic disease process
proposed that they may be a dynamic or functional lesion
like a problem in the software rather than the hardware of the body
examples of common functional symptoms?
pain altered sensation dizziness movement disorders weakness seizures cognitive symptoms fatigue cramps bladder or bowel problems
what is dissociation vs deoersinalisation vs derealisation?
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who is most likely to respond to treatment for functional disorders?
patient’s own view that they are likely to get better (i.e if they believe their condition is unique and strange and unlikely to change they wont get better)
early presentation
hopelessness, despair and entrapment feelings make people less likely to get better
what can be done for functional disorders?
take time to listen - can often be the best thing
- ask about clear timescale, an disability, dissociation (dizzy/faint), other medical experiences and illness beliefs
- ask about past medical, psychological and functional history
- fully examine the patient (inconsistent findings common in functional symptoms)
possible common findings in functional disorders?
charcots gait
walking on ice gait?
pseudoptosis
hoover’s sign
important aspects of the formulation in functional disorders?
apply to patients context and be understood
make clear that this is common, not weird and doctors see it often
include validation - symptoms are genuine, not imagining it
include reversibility (symptoms can get better)
remove blame - not your fault you have these symptoms
but - you will need to put some effort into getting better
treatment of functional disorders?
formulation
treat the treatable aspects (co-morbid psychiatric illness etc)
CBT = standard treatment of choice
tricyclic antidepressants
breathing retraining (panic disorder/hyperventilation)
