Munchhausen Syndrome & Somatic Symptoms Flashcards
Most common symptoms of Munchausen
Bleeding from various sites
Seizures
CNS depression
Apnea
Munchausen by Proxy common presentations
GI bleed
UTI
Vomiting/reflux
Diarrhea
Apnea (potential for SIDS)
Hypoglycemia
Key to Munchausen Diagnosis
Complete history
Somatic Disorder
Overly preoccupied w/ health or appearance
Physical complaints w/o medical condition - >6 months
-Somatic sx significantly disrupt daily life
Men are more likely to be Dx w/ antisocial personality
Tx: Assign 1 PCP to cut down specialty visits
-reduce supportive consequences of discussing symptoms at great lengths - redirect them
Conversion Disorder
Physical symptoms suggesting neurological problems
- sensory impairment (blindness)*** w/o identifiable cause
- Paresthesias (Paralysis, numbness)*** w/o identifiable cause
Onset rare <10 yo and >35 yo
Right hemisphere involved, trauma usually involved
Tx: Attend to trauma, redirect w/ sx, remove secondary gain success
La belle indifference
1/3 all conversion disorders
Inappropriate complacent attitude with whatever is going on
More common in women
Illness Anxiety Disorder
New term for hypochondriac
No physical sx, serious anxiety about possible having a diagnosis
Over-report bodily sensations as sx of serious disease
-no insight, skewed perception
Chronic course that waxes/wanes
Tx: Challenge illness-related misinterpretations, provide more substantial and sensitive reassurance
Brief somatic disorder or illness anxiety disorder
Lasts less than 6 months
Meets all criteria for illness anxiety disorder except D
Illness anxiety disorder w/o excessive health-related behaviour
D: Excessive health behaviours or maladaptive avoidance
Pseudocyesis
False belief that you are pregnant
Somatoform NOS
All sx of pregnancy w/o actual fetus
Body Dysmorphic Disorder
Excessive concern w/ real/imagined defect in appearance - usually face or genitals
Culturally influenced but not bound - plastic surgery common but doesn’t help
Fixation w/ or avoidance of mirrors
Suicidal ideation/behavior is common
Chronic, starts in adolescents
Tx: CBT, SSRI for relief