Psychological problems presenting with physical symptoms

Question 1

What is thw word used for when mental factors such as stress cause physical symptoms?

Answer 1

• Called Somatisation
• Somatoform disorders are a severe form of somatisation where physical symptoms can cause great distress, often long-term.
• BUT people with somatoform disorders are usually convinced that their symptoms have a physical cause

Question 2

What is somatisation?

Answer 2

When physical symptoms are caused by mental (psychological) or emotional factors it is called somatisation. e.g. many people have occasional headaches caused by mental stress.

Question 3

What are some physical symptoms a patienet suffering from stress and other mental health problems might complain of?

Answer 3

• Chest pains.
• Tiredness.
• Dizziness.
• Back pain.
• Feeling sick (nauseated).

Question 4

How can the minds cause physical symptoms?

Answer 4

• The relationship between the mind and body is complex and not fully understood.
• When we somatise, somehow the mental or emotional problem is expressed partly, or mainly, as one or more physical symptoms.
• IMPORTANT- ,the symptoms are real and are not imagined. You feel the pain, have the diarrhoea, etc.

Question 5

What is the relationship between somatisation and functional symptoms?

Answer 5

• Some doctors prefer to use the term functional when no known physical cause can be found for a physical symptom.
• A functional symptom means a function of the body is faulty (for example, there may be pain or diarrhoea) but we don’t know the cause.
• The cause may be due to mental factors (somatisation), physical factors not yet discovered, or a combination of both.
• Another term which is sometimes used is medically unexplained symptoms (MUS),

Question 6

What are some somatoform disorders?

Answer 6

*The somatoform disorders are the extreme end of the scale of somatisation. So, the physical symptoms persist long-term, or are severe but no physical disease can fully explain the symptoms

• Somatisation disorder.
• Hypochondriasis.
• Conversion disorder.
• Body dysmorphic disorder.
• Pain disorder.

Question 7

What are the main symptoms of Somatisation disorder?

Answer 7

People with this disorder have many physical symptoms from different parts of the body - for example:

• Headaches.
• Feeling sick (nauseated).
• Tummy (abdominal) pain.
• Bowel problems.
• Period problems.
• Tiredness.
• Sexual problems.

Question 8

who is more likely to get somatisation disorder? How might they act? are the symptoms constant?

Answer 8

• symptoms can vary at different times
• people tend to be emotional about symptoms describe them as ‘unbearable’
• symptoms can wax and wane in severity
• cause - perhaps due to an unconcsious desire for help
• often develops between ages of 18-30
• more women than men
• no physical disease can account for symptoms in all investigations

Question 9

What is Hypochondriasis?

Answer 9

• people fear that minor symptoms may be due to a serious disease. i.e., that a minor headache may be caused by a brain tumour, or a mild rash is the start of skin cancer.
• normal bodily sensations such as ‘tummy rumbling’ may be thought of as a symptom of serious illness.
• People with this disorder have many such fears and spend a lot of time thinking about their symptoms.

Question 10

Compare Hypochondriasis to somatisation disorder

Answer 10

Difference (they are similar)
* people with hypochondirasis may accept their symptoms are minor but believe or fear they are causes by a serious disease
* believe the doctor has not found the root cause

Question 11

What is conversion disorder?

Answer 11

• has symptoms which suggest a serious disease of the brain or nerves (a neurological disease) - i.e.
• Total loss of vision (severe sight impairment).
• Deafness.
• Weakness, paralysis or numbness of the arms or legs.

Question 12

When do symptoms of conversion disorder usually manifest? Age? how long do symptoms last?

Answer 12

• The symptoms usually develop quickly in response to a stressful situation - person unconsciously convert your mental stress into a physical symptom.
• tends to occur between the ages of 18 - 30 years.
• Symptoms often last no longer than a few weeks but can persist long-term
  *
• can be just one episode / can have repeated

Question 13

What is a psychosomatic Disorder?

Answer 13

• Psychosomatic means mind (psyche) and body (soma).
• A psychosomatic disorder is a disease which involves both mind and body.
• Some physical diseases are thought to be particularly prone to being made worse by mental factors such as stress and anxiety.
• Your mental state can affect how bad a physical disease is at any given time

Question 14

explain how there are mental and physical aspects to any disease

Answer 14

Mental
* how we react to disease varies from person to person. i.e. one pt may be unconcerned by the psoriasis rash while naother might make them feel very depressed and more ill

Physical
* i.e. some mental illnessess may cause some people to not eat, take care of themselves, which can cause physical problems.

Question 15

The Merriam-Webster dictionary defines psychosomatic as: of, relating to, involving, or concerned with bodily symptoms caused by mental or emotional disturbance.

What PHYSICAL diseases are thought to be particularly prone to being made worse by mental factors

Answer 15

These include:
* psoriasis
* eczema
* stomach ulcers
* high blood pressure
* heart disease.

Question 16

How are somatisation disorders treated?

Answer 16

1
* Be emotionally warm to patients - offer emotional acceptance, and practical advice
* focus on the conversation should be supportive and not about proving that nothing is wrong with them

2. • Talking therapy e.g. CBT as somatistion ca n be rooted in anxiety or depression. E.g. in some communities it is easier to talk about physical symptoms than discuss mental health

3
* Ideally there should be ioint clincis with med and psychiatry - dr millward says this doesnt happen