Medically unexplained symptoms Flashcards
Define medically unexplained symptoms
a person experiences physical symptoms for which no clear organic pathology is found
Define somatisation
a person experiences and communicates psychological distress in the form of physical symptoms and seeks medical help
Define persistent physical symptoms
umbrella term to describe distressing somatic complaints, regardless of cause, that are present on most days for at least several months
Predisposing factors for multiple medically unexplained symptoms/persistent physical symptoms
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
Principles of management of medically unexplained symptoms
acknowledge reality of symptoms
offer positive explanation
emotional support
avoid ambiguity
identify + treat anxiety + depression
consider CBT/medication (SSRI)
Define illness anxiety disorder
preoccupation with and fear of having or acquiring a serious disorder
fears + symptoms >6mo despite reassurance and thorough medical evaluation
Define factitious disorder
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’
Describe Munchausen syndrome
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
Describe Munchausen by proxy
factitious disorder imposed on another
carer fabricates illness symptoms in a child or vulnerable adult
a form of child abuse
Define malingering
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
Describe dissociative (conversion) disorders
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