Liaison Psychiatry and Medically unexplained symptoms

Question 1

What is Liaison Psychiatry?

Answer 1

A subspecialty of psychiatry concerned with the assessment and management of psychiatric and psychological illnesses in the general medical population.

Question 2

What psychiatric disorder may arise from Hyperthyroidism?

Answer 2

Anxiety disorder

Question 3

What psychiatric disorder may arise from Cushing’s disease?

Answer 3

Depression

Question 4

What is a psychiatric side effect of steroids?

Answer 4

Mania

Delirium

Question 5

What is psychiatric disorder may arise from Parkinson’s disease?

Answer 5

Psychosis as a result of medication

Question 6

What psychiatric disorder may arise following amputation or cancer?

Answer 6

Adjustment disorder

Question 7

Name 4 factors of physical illness that can influence the development of psychiatric illness

Answer 7

Disability
Reduced self esteem
Hopelessness
Sick role
Dependency and restricted social circle
Financial problems
Drug side effects
Biological effects of physical illness: systemic or brain

Question 8

Name 5 common indications for liaison psychiatry

Answer 8

Amongst the general medical population:

• Deliberate self-harm or suicidal ideation
• Issues of consent, capacity, or Sectioning
• Advice in patients with psych Hx
• Mood or anxiety symptoms
• Confusion or cognitive impairment
• Psychotic symptoms
• Drug and alcohol problems
• Eating disorders
• Medically unexplained symptoms

Question 9

What are the types of Medically Unexplained Symptoms?

Answer 9

Functional somatic illness
Conversion and dissociative disorders
Pain disorders
Somatisation disorder
Factitious disorder (Munchausen's syndrome)
Malingering

Question 10

What is Somatisation?

Answer 10

Experience of physical symptoms with no sufficient physical cause, with presumed psychological causation.

Question 11

What is somatisation disorder?

Answer 11

Repeated presentation with medically unexplained symptoms, affecting multiple organ symptoms.

Question 12

What are the characteristics of somatisation disorder?

Answer 12

At least 2 years of multiple and variable unexplained physical symptoms.
Persistent refusal to accept advice and reassurance.
Some impairment of family and social functioning.

Question 13

What are conversion and dissociative disorders?

Answer 13

Loss or disturbance of normal motor or sensory function, attributed to psychological cause.

Question 14

Name 2 clinical features seen in dissociative disorders

Answer 14

(Mental change in function attributed to psychological cause)
Amnesia
Personality change
Fugue - amnesia + wandering outside normal environment

Question 15

Name 2 clinical features seen in conversion disorders

Answer 15

(Physical change in function attributed to psychological cause)
Paralysis
Sensory loss
Seizures
Blindness

Question 16

What is Hypochondriasis?

Answer 16

Preoccupation with the fear of having a serious illness. Persists despite negative investigations and repeated reassurance. Causes distress and functional impairment.

GI diseases are the most common presentation.

Question 17

What is Munchausen’s syndrome/Factitious disorder?

Answer 17

Intentional feigning of own signs, symptoms, and history with the intent of entering the sick role.

Question 18

What is Munchausen’s syndrome by proxy?

Answer 18

Intentional feigning of another’s signs, symptoms, and history with the intent of entering the sick role.

Question 19

What is Malingering?

Answer 19

Intentional feigning of own signs, symptoms, and history with the intent of personal or financial gain.