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Psychiatry3 > Psychosomatic illness > Flashcards

Psychosomatic illness Flashcards

1
Q

What are functional disorders?

A

Traditionally a reversible disturbance in organ function but now may include many syndromes.

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2
Q

What is somatic symptom disorder?

A

Excessive thoughts, feelings, or behaviours related to the symptom/s.

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3
Q

What is illness anxiety disorder?

A

Preoccupation with having a serious illness.

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4
Q

What are the criticisms of current medical terms regarding symptoms?

A

Criticism includes :
* dualistic thinking (organic vs non-organic), these categories, potentially oversimplifying complex issues
* it questions what qualifies as a medical explanation, notes that evidence for causality is often unclear,
* “persistent physical symptoms” may be more acceptable for patients than “medically unexplained symptoms.”

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5
Q

What percentage of patients in primary health care have somatisation symptoms?

A

20%.

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6
Q

What percentage of patients in specialist clinics have medically unexplained symptoms related to GIT?

A

53%

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7
Q

What percentage of patients in specialist clinics have medically unexplained symptoms related to neurology?

A

42%.

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8
Q

What percentage of patients in specialist clinics have medically unexplained symptoms related to cardiology?

A

32%.

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9
Q

hat percentage of patients with medically unexplained symptoms (MUS) have co-morbid depression, anxiety, or somatic disorder?

A

50%.

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10
Q

What are the implications of somatic symptoms on health care?

A

They lead to high health care consumption and impaired function.

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11
Q

What is central sensitization?

A

A condition where the central nervous system becomes hyper-responsive to stimuli, increasing pain perception.

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12
Q

What factors can contribute to central sensitization?

A

Tissue injury, psychological distress, ongoing stimuli, and influences from genetic factors.

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13
Q

What conditions are often associated with central sensitization?

A

Chronic pain conditions such as fibromyalgia and other chronic pain syndromes.

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14
Q

what is hyperalgesia ?

A

increased sensitivity to pain, where a painful stimulus feels more intense

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15
Q

what is allosynia ?

A

when a normally non-painful stimuli cause pain.

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16
Q

What is the role of glutamate and substance P in pain perception and central sensitization?

A

Increased release of glutamate and substance P enhances pain signaling in the nervous system, contributing to heightened pain sensitivity and the development of conditions like hyperalgesia and allodynia

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17
Q

What does the biopsychosocial model encompass?

A

It includes biological(pain memory /prior injury), psychological, and social factors that influence health and illness.

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18
Q

What psychological factors are considered in the biopsychosocial model?

A
  • Coping style
  • beliefs
  • expectations
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19
Q

What memory /prior injury related factors are included in the biopsychosocial model?

A
  • memories about pain
  • Genetic factors
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20
Q

What social factors are part of the biopsychosocial model?

A

occupation, family, and support.

21
Q

Which factors contribute to central sensitization?

A

On going stimulus ,Genetic factors, tissue injury, and autonomic activity.

22
Q

What is a key requirement for diagnosing Somatic Symptom Disorder?

A

One or more physical symptoms that are distressing or cause disruption in daily life.

23
Q

What are the excessive thoughts, feelings, or behaviors related to in Somatic Symptom Disorder?

A
  1. Ongoing thoughts disproportionate to the seriousness of symptoms
  2. High levels of anxiety about health or symptoms
  3. Excessive time and energy spent on symptoms or health concerns
24
Q

How many symptoms must be present for a diagnosis of Somatic Symptom Disorder?

A

At least one symptom must be constantly present, although symptoms may vary and come and go.

25
Q

Where do individuals with Somatic Symptom Disorder typically seek help?

A

They usually go to a primary care physician rather than a psychiatrist or mental health professional.

26
Q

What difficulty do individuals with Somatic Symptom Disorder often experience?

A

They may have trouble accepting that their concerns about their symptoms are excessive and remain fearful despite evidence of no serious condition.

27
Q

What is a common dominant symptom in some individuals with Somatic Symptom Disorder?

A

Pain.

28
Q

What are the key steps in the consultation process for managing patients with somatic symptoms?

A
  • Review physical symptoms
  • address and acknowledge patient concerns
  • provide feedback on investigations
  • explore the history of symptoms through reattribution
  • use an appropriate explanatory model for the patient.
29
Q

What is the first step in the consultation/diagnosis process?

A

Review of physical symptoms.

30
Q

Why is it important to address and acknowledge a patient’s concerns during consultation?

A

It helps build trust and ensures the patient feels heard and validated.

31
Q

What should be provided to the patient regarding investigations?

A

Feedback on investigations while acknowledging the reality of their symptoms.

32
Q

What does reattribution involve in the consultation process?

A

Exploring the history of the patient’s symptoms.

33
Q

What is crucial when using an explanatory model during consultation?

A

It should be appropriate for the patient.

34
Q

What is the explanatory model in healthcare?

A

It is a framework used to understand and communicate a patient’s symptoms and health concerns, considering their beliefs, cultural background, and personal experiences to tailor diagnosis and treatment.

35
Q

What types of treatment are included in the management of patients with somatic symptoms?

A

Specific pharmacological treatment and psychotherapy.

36
Q

How can a symptom diary be useful in management?

A

It helps track symptoms over time, providing valuable insights for treatment adjustments.

37
Q

What therapeutic model is often utilized in managing somatic symptoms?

A

The Cognitive Behavioral Therapy (CBT)

38
Q

What are the key components of managing patients with somatic symptoms?

A
  • Establishing a therapeutic relationship
  • ensuring regular follow-up
  • implementing harm reduction strategies
  • and maintaining comprehensive medical reports.
39
Q

What is a key characteristic of conversion disorder?

A

It involves neurological symptoms that cannot be explained by medical conditions.

40
Q

How is conversion disorder typically diagnosed?

A

Through the exclusion of other medical or neurological conditions that could explain the symptoms.

41
Q

What is the primary feature of Functional Neurological Symptom Disorder?

A

One or more symptoms of altered voluntary motor or sensory function.

42
Q

How must the symptoms of Functional Neurological Symptom Disorder be characterized?

A

They must be incompatible with recognized neurological or medical conditions.

43
Q

What is required for a diagnosis of Functional Neurological Symptom Disorder regarding the patient’s functioning ?

A

The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

44
Q

Can the symptoms of Functional Neurological Symptom Disorder be better explained by another medical condition?

A

No, the symptoms cannot be better explained by another medical condition or disorder.

45
Q

What is the primary characteristic of Factitious Disorder?

A

Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception.

46
Q

What is the motivation behind the behavior in Factitious Disorder?

A

The behavior is motivated by a desire to assume the sick role, not for external rewards (e.g., financial gain).The deceptive behaviour is evident even in the absence of external rewards .

47
Q

How must the symptoms of Factitious Disorder be presented?

A

The individual presents themselves as ill, impaired, or injured

48
Q

What is required for a diagnosis of Factitious Disorder regarding the awareness of the deception?

A

The individual is aware that they are fabricating or inducing symptoms.

49
Q

an Factitious Disorder be diagnosed if the symptoms are better explained by another mental disorder?

A

No, the symptoms must not be better explained by another mental disorder, such as a delusional disorder.

Psychiatry3 (7 decks)

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