Psychosomatic illness Flashcards
Functional disorder
Traditionally a reversible disturbance in organ function but now may include many syndromes.
Medically unexplained symptoms
new term seen more often in recent literature.
Somatic symptom disorder
Excessive thoughts, feelings or behaviours related to the symptoms.
Illness anxiety disorder
Preoccupation with having a serious illness.
Prevalence
Primary health care: 20% have somatisation symptoms1 (WHO study 15 countries almost 26000 patients).
Medically Unexplained Symptoms in specialist clinics: GIT 53%, neurology 42%, cardiology 32%2
+_ 50% of patients with MUS have co-morbid depression/anxiety/somatic disorder
High health care consumption, impaired function
Biopsychosocial Model
Case 1 example: chronic pain
Central sensitization: Tissue injury, Automatic activity, Genetic factors, Ongoing stimulus.
Psychological distress: coping style, beliefs, expectations.
Pain memory/prior injury: memories about pain, genetic factors.
Social/cultural factors: occupation, family, support.
DSM 5 Criteria: Conversion disorder
A. One or more symptoms of altered voluntary motor or sensory function.
B. Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions.
C. The symptom or deficit is not better explained by another medical or mental disorder.
D. The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.
DSM 5 Criteria: Factitious Disorder
A. Falsification of physical or psychological signs or symptoms, or induction of injury or
disease, associated with identified deception.
B. The individual presents himself or herself to others as ill, impaired, or injured.
C. The deceptive behavior is evident even in the absence of obvious external rewards.
D. The behavior is not better explained by another mental disorder, such as delusional
disorder or another psychotic disorder.
