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Yr 4 - Psychiatry > Other Disorders > Flashcards

Other Disorders Flashcards

1
Q

What are the somatoform disorders?

A

The somatoform disorders are a group of psychiatric disorders that cause unexplained physical symptoms.

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2
Q

What is somatisation?

A

The tendency to experience psychological distress in the form of somatic symptoms and to seek medical help for these symptom

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3
Q

What are dissociative disorders?

A

Also known as conversion disorders.

Dissociative disorders are a range of conditions that can cause physical and psychological problems. Can occur following a traumatic life event.

This leads to the disruption of:
- Consciousness
- Memory
- Identity
- Perception

There is NO organic basis.

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4
Q

Give some symptoms of dissociate disorders

A

Partial/complete loss between memories of past, awareness of identity and immediate sensations, and control of bodily movements:
- feeling disconnected from yourself and the world around you
- forgetting about certain time periods, events and personal information
- feeling uncertain about who you are
- having multiple distinct identities
- feeling little or no physical pain

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5
Q

What is the theory behind dissociative/conversion disorders?

A

Conversion of anxiety symptoms into more
tolerable physical symptoms

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6
Q

Clinical signs of dissociate disorders

A
  • Paralysis – 1/more limbs, or side of face/body
  • Aphonia (loss of speech)
  • Sensory loss – not fitting with dermatomes
  • Seizures – generalised shaking, no tongue
    biting/incontinence/injury
  • Amnesia – memory loss, most often for recent events
  • Fugue – all features of dissociative amnesia, plus purposeful travel beyond usual every day range
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7
Q

How do dissociative disorders differ from factitious disorder or malingering?

A

unlike factitious disorders and malingering, the symptoms of somatoform disorders are not intentional or under conscious control of the patient

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8
Q

Management of dissociative disorders?

A
  • Exclude organic nature of disease
  • Acceptance and support
  • Physical rehabilitation
  • Treatment of comorbid mental disorder
  • Clear presentation of diagnosis
  • Avoid interventions which maintain the sick role/prolong abnormal features
  • CBT/IPT, supportive psychotherapy
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9
Q

Which dissociative disorder is typically seen following traumatic or stressful events?

A

Dissociative amenesia (loss of memory)

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10
Q

Give some other dissociative disorders

A
  • dissociative fugue
  • dissociative stupor
  • dissociative motor disorders
  • dissociative anaesthesia
  • trance and possession disorders
  • dissociative compulsions (i.e. seizures with no organic basis)
  • Gander syndrome
  • Multiple personality disorder
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11
Q

What happens in dissociative fugue?

A

o Sudden, unexpected, memory loss and
confusion about identity or assumption of
another identity
o May last several months
o After fugue ends all memory of it is lost

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12
Q

What happens in trance and possession disorders?

A

o Temporary replacement of identity with a ghost/ spirit/deity/other person/animal/object
o Not seen by patient’s culture as acceptable

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13
Q

What happens in dissociative anaesthesia?

A

Loss of sensation

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14
Q

What happens in dissociative motor disorders?

A

Paralysis of muscle groups
Ataxia–> inability to stand or walk

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15
Q

What are somatoform disorders?

A

Medically unexplained symptoms

  • Physical symptoms that cannot be accounted for by a physical disorder or other mental disorder
  • Frequently accompanied by anxiety or depression
  • Requests for medical investigations, in spite of repeated negative findings and reassurance
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16
Q

Management of somatoform disorders?

A
  • Acceptance
  • Clear and consistent explanation for the symptoms
  • Reassure patient of continuing care
  • Reduce/stop unnecessary medication
  • Keep investigations to a minimum
  • CBT and treatment of comorbid mental health disorders
16
Q

Assessment of somatoform disorders?

A
  • Look at previous medical records
  • Full details of current symptoms
  • Explore illness beliefs
  • Explore psychiatric history
17
Q

What childhood event are somatoform disorders typically associated with?

A
  • Often history of childhood illness or increased parental anxiety
  • Associated with childhood sexual abuse
18
Q

Different somatoform disorders:

A
  • Somatisation disorder
  • Hypochondrial disorder
  • Conversion disorder
  • Persistent somatoform pain disorder
  • Somatoform autonomic disorder
19
Q

What is somatisation disorder?

A
  • A long history of multiple, severe, frequently changing physical symptoms that cannot be accounted for by a physical disorder or other mental disorder
  • Course chronic and fluctuating, often associated with disruption of social, interpersonal and family behaviour
20
Q

Is somatisation disorder more common in males or females?

A

Females

21
Q

What is hypochondrial disorder?

A

Persistent preoccupation with possibility of
having one or more serious and progressive physical disorders – eg cancer

Manifest persistent somatic complaints despite medical reassurance to the contrary

22
Q

What population is at risk of hypochondrial disorder?

A

Med students (especially males)

23
Q

What is malingering?

A

Manufacturing or exaggerating psychological and physical symptoms for a purpose other than assuming the sick role

For financial or other gain such as:
* Evading the police
* Claiming compensation
* Obtaining drugs – eg exaggerating pain to obtain morphine
* Obtaining shelter for the night

N.B. this is NOT a mental disorder

24
Q

What is Munchausen Syndrome?

A

Factitious disorders are manufactured or exaggerated for the purpose of assuming the sick role

Fabricating signs of physical/mental disorder with primary aim of obtaining medical attention and treatment

25
Q

What is an adjustment disorder?

A

A protracted response to a significant life event or life change characterised by significant emotional distress and disturbance that interferes with normal social functioning

E.g. migration, change of job, divorce, bereavement

26
Q

Symptoms of adjustment disorder?

A
  • Depressive symptoms
  • And/or anxiety symptoms
  • Inability to cope
  • Not severe enough to warrant a diagnosis of
    depressive or anxiety disorder
  • But impacts on social functioning
27
Q

When do symptoms of adjustment disorder occur after the stressor?

A
  • Occurs within 1 month of particular stressor
  • Shouldn’t persist longer than 6 months after
    stressor is removed
28
Q

What are some risk factors for depression following bereavement?

A
  • Previous history of depression
  • Intense grief/depressive symptoms early on
  • Few social supports
  • Little experience of death
  • Traumatic/unexpected death
29
Q

A differential diagosis for adjustment disorder is Acute Stress Reaction (ASR). What is this?

A

This is a transient disorder that develops in response to exceptional physical and/or mental stress

30
Q

How long does ASR typically last?

A

Typically subsides within hours or days. It should last no more than one month.

Yr 4 - Psychiatry (17 decks)

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