Medically Unexplained Symptoms Flashcards
What is a somatoform disorder?
A condition whereby there are physical symptoms in the absence of physiological illness. Sufferers frequently seek medical attention.
What is a dissociative (conversion) disorder?
A condition whereby there are physical symptoms in the absence of pathology, and which have a clear relationship with stressful events
What is “somatisation”?
Experience of physical symptoms with no or insufficient physical cause
In what contexts might somatisation occur?
- Psych conditions
- As a functional somatic syndrome, e.g. fibromyalgia, chronic fatigue, IBS
- In the context of a somatoform disorder
List the somatoform disorders
“PUSSH”
- Persistent somatoform pain disorder
- Undifferentiated somatoform disorder
- Somatization disorder
- Somatoform autonomic dysfunction
- Hypochondrical disorder
Briefly describe the key features of somatization disorder
- Multiple, recurrent, frequently changing physical symptoms without physical explanation
- Preoccupation with symptoms - ++Ix
- Refusal to accept reassurance there is nothing wrong
- 6+ physical symptoms for 2+ yrs
What is the key feature of somatoform autonomic dysfunction?
Symptoms relate to ANS
Must have multiple symptoms from more than 1 system
What are the key features of persistent somatoform pain disorder?
6+ months of severe pain that cannot be (fully) explained
Usually due to psychosocial stressors
What are the key features of hypochondriacal disorder?
Patient misinterprets normal bodily sensations/mild symptoms, leading to non-delusional preoccupation that they have a serious physical disease. Refuse to accept reassurance.
What are the 2 major processes which occur in dissociative disorder? Briefly explain.
Dissociation - psychological defence mechanism whereby memories “separated off” from conscious self.
Conversion - memories converted into physical symptoms - easier to bear/communicate.
Describe the sequence of events in a dissociative disorder
Distressing event –> emotional distress –> dissociation –> conversion –> gain (primary and/or secondary)
What sorts of symptoms are most likely in dissociative disorder?
Neurological
List some symptoms of dissociate disorder
- Motor - e.g. paralysis
- Sensory - e.g. pain
- Dissociative amnesia - failure to recall periods of life/certain events
- Dissociative fugue - patient loses memory and wanders away from usual surroundings
- Dissociative stupor - patient motionless and mute, does not respond to stimuli.
What is factitious disorder (Munchausen’s)?
Illness feigned or intentionally produced for primary gain - i.e. adoption of sick role, illness identity, being cared for
What is malingering?
Illness feigned or intentionally produced for secondary gain - i.e. to avoid work, receive benefits, avoid jail etc…
