Medically unexplained symptoms Flashcards

1
Q

Define medically unexplained symptoms

A

a person experiences physical symptoms for which no clear organic pathology is found

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2
Q

Define somatisation

A

a person experiences and communicates psychological distress in the form of physical symptoms and seeks medical help

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3
Q

Define persistent physical symptoms

A

umbrella term to describe distressing somatic complaints, regardless of cause, that are present on most days for at least several months

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4
Q

Predisposing factors for multiple medically unexplained symptoms/persistent physical symptoms

A

long term conditions with anxiety/depression
childhood adversity/abuse
can overlap with personality disorder
recent infection, current physical illness, severe illness or death or a close relative

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5
Q

Principles of management of medically unexplained symptoms

A

acknowledge reality of symptoms
offer positive explanation
emotional support
avoid ambiguity
identify + treat anxiety + depression
consider CBT/medication (SSRI)

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6
Q

Define illness anxiety disorder

A

preoccupation with and fear of having or acquiring a serious disorder
fears + symptoms >6mo despite reassurance and thorough medical evaluation

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7
Q

Define factitious disorder

A

conscious feigning of symptoms and signs of disease to deceive doctors
patient aware of deception but little or no insight into motives
usually motive = stay in ‘sick role’

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8
Q

Describe Munchausen syndrome

A

form of factitious disorder
‘hospital addiction’
usually present as emergency eg. acute abdomen, haematemesis
totally invented history, may be false name
aim to have intervention eg. major surgery

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9
Q

Describe Munchausen by proxy

A

factitious disorder imposed on another
carer fabricates illness symptoms in a child or vulnerable adult
a form of child abuse

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10
Q

Define malingering

A

feigned illness where subject is conscious both of simulating their symptoms and the purpose or nature of potential gain
eg. injury compensation, medical discharge from army, get drugs/money

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11
Q

Describe dissociative (conversion) disorders

A

usually acute (eg. after major stress) and often dramatic (eg. fits/amnesia/blindness)

patients often not distressed by their symptoms ‘belle indifference’
disorder may reduce initial psychological distress

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