Health Anxiety, Somatization and unexplained disorders Flashcards
Health Anxiety definition
excessive health-related concerns with somatic perceptions and reassurance seeking behaviors
Somatisation definition
psychological distress manifesting in physical symptoms - help-seeking
Hypochondria disorder definition
> 6 month of persistent worry about having a serious illness despite having medical reassurance
What sex is affected more by health anxiety + by how much
F>M 10:1
What are the 3 subtypes of health anxiety disorders + what are their definitions
1) cognitive - increased cognitive awareness + increased fear
2) somatizing - increased symptom awareness and more body symptoms
3) behavioural - increased disease conviction and avoidance
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how do you diagnose a somatisation disorder
must be >2 years of multiple physical symptoms involving at least 2 different organ symptoms with multiple items, and can’t be medically explained
reassurance is not effective
How do you diagnose a hypochondria disorder
> 6 months of a persistent belief of the presence of 1-2 serious physical diseases
OR
preoccupation with belief and symptoms that cause functional impairment and help-seeking
OR
persistent refusal to accept medical reassurance
What is a factitious disorder
AKA Munchausen’s
feigns/exaggerates symptoms for no reason, often causing self harm in order to gain medical attention
what is the definition of malingering
conscious manufacturing of symptoms for secondary gain
what are some examples of abnormal illness behaviour
going to Drs often Not wanting to get better Denying an issue illness behavior continuing beyond an appropriate timescale too many tablets/aids
what is the definition of a dissociative/conversion disorder
Traumatic event leading to disruption in previously functional areas of consciousness, memory, identity or perception E.g. someone with amnesia after a significant event
There is often no insight
what are some common presentations of conversion/dissociative disorders
Amnesia Stupor Motor Disturbance Fuge Trance Sensory loss Pseudo-seizures
What are the most common comorbidities that accompany somatoform disorders (+%s)
Anxiety (33%) Depression (50%) Phobias Schizophrenia OCD Panic disorder
What important comorbidity is NOT associated with somatoform disorders
Drug use
Wha are the principles of management for somatiform disorders
1) Keep in primary care
2) Establishing a good rapport is essential - ensure the patient is heard and move convo from a ‘cure’ to symptom management
3) limit jargon use
4) schedule regular appointments with same healthcare professional
5) attempt to introduce psychological component of disease
BioPsycoSocial approach for somatoform disorders
BIO usually long term effectiveness weak SSRI/SNRI may be useful hypochondrial delusion = antipsychotic AVOID BENZOs
PSYCHO
CBT
psychoeducation
SOCIAL
encourage normal function
involve supportive network
what is the link between physical and mental health
Schizophrenia
2x risk of death from CVD
3x risk of death from resp disease
3x as likely to smoke
Stress is linked to increased cancer mortality
Depression
increased risk of ischaemic heart disease
2x as likely to smoke
What are the differentials for medically unexplained symptoms
Depression/Anxiety
Some organic disorder (ME,SLE)
dissociative/conversion disorder
Psychosis/Schizophrenia
What are the best ways to tell between a real disease presentation and some somatisation
no explanation for disease occurring
complaint is exaggerated/out of proportion for disease state
