Functional Disorders Flashcards
what are functional symptoms
symptoms that cannot be associated with identifiable organic disease process
what are some common functional symptoms
Pain Altered sensation Dizziness Movement disorders Weakness Seizures Cognitive symptoms
what is dissociation
detachment from reality
what is depersonalisation
feeling that your body doesn’t quite belong to you or it disconnected from you
what is derealisation
feeling you are disconnected from the world around you - spaced out
who is most likely to respond to treatment for a functional disorder
Having the view that things may be amenable to change
Time to presentation
Hopelessness, despair and entrapment = poor predictors
how should you take a history of someone with a functional disorder
Take time over history - make them feel listened to Get clear timescale Ask about disability Ask about dissociation (dizzy, faint) Ask about other medical experiences Illness beliefs? PMH Previous functional symptoms Psychiatric history and mood at the end
what to look for in examination of functional disorders
elicit functional signs - later explain them to the patient
inconsistent findings are common - use them to ur benefit
what factors make up the formulation for functional disorders
thoughts mood social factors physiology behaviour
important things to include in the formulation for the patient
Include normalisation Include validation of symptoms Include concept of reversibility Remove blame BUT remind that it will take some effort to get better
treatment for functional disorders
Formulation Treat the treatable - comorbid psych illness CBT Tricyclic antidepressants Breathing retraining
