Lectures 37 + 38 - Somatic Symptoms

Question 1

_______ disorder and _______ are considered Conscious production of Somatic symptoms.

What’s the distinction between each.

Answer 1

Factitious disorder

Malingering

In Factitious disorder, the symptoms are feigned for psychological reasons, while with Malingering, symptoms are feigned for tangible gain.

Question 2

Primary Gain refers to the _______ (unconscious or conscious?) expression of an unaccepted emotion as somatic symptoms to avoid dealing with that emotion. The patient may be consciously feigning the symptoms while unconscious as to the reason.

Secondary Gain refers to feigning symptoms for a known reward, so in this case, the patient is _______ (unconscious or conscious?) of the reason.

Answer 2

Unconscious

Conscious

Question 3

Somatic Symptom disorder is defined as patients expressing at least 1 of the following:

________ and persistent thoughts about the seriousness of the symptoms.

Persistently high level of _____ about their health or symptoms.

Excessive _____ and ______ devoted to the symptoms.

Keep in mind any single somatic symptom may not be continuously present, BUT the patient will consistently be in a symptomatic state (typically more than 6 months).

How are Mild, Moderate, and Severe Somatic Symptom disorder classified?

Answer 3

Disproportionate and Persistent

High levels of anxiety

Excessive Time and Energy

Mild –> 1 symptom

Moderate –> 2 symptoms

Severe –> more than 2 symptoms

Question 4

Generalized Anxiety Disorder (GAD) differs from Somatic Symptom disorder in that the patient worries about what?

Answer 4

Many events/situations, including those OUTSIDE of somatic symptoms.

Question 5

________ disorder differs from Somatic Symptom disorder in that patients complain of Neurological issues rather than general aches and pains. It affects Voluntary Motor actions and Primary sensory system.

Answer 5

Conversion disorder

Question 6

_______ _______ disorder is the new medical term for Hypochondriacs. There aren’t any symptoms, but the patient fears they have a disease.

There are 2 types:

1. Care-seeking
2. Care-avoidant

Answer 6

Illness Anxiety disorder

Question 7

The difference between Illness Anxiety d/o and OCD is what?

Answer 7

OCD patients are worried they will contract/develop a disease, while Illness Anxiety disorder patients are worried they actually have a disease.

Question 8

What is Hoover’s sign, and how does it pertain to Conversion d/o?

Answer 8

Hoover’s sign is when muscle tension is observed in a limb or muscle group the patient believes to be paretic when they move the non-paretic limb/muscle group BUT there is no contraction felt in the non-paretic limb/muscle group when the paretic limb/muscle group is being attempted. Essentially, it shows there is muscle contraction in the “paretic” aspect, but the patient does not try to move it when asked to.

Question 9

La belle indifference is exactly as it suggests, a “beautiful indifference” to one’s symptoms. It is typically present in patients with ______ d/o.

Answer 9

Conversion d/o

Question 10

________ is the term for a patient who falsely believes she is pregnant.

Answer 10

Pseudocyesis