Psychosomatic illness Flashcards
What are functional disorders?
Traditionally a reversible disturbance in organ function but now may include many syndromes.
What is somatic symptom disorder?
Excessive thoughts, feelings, or behaviours related to the symptom/s.
What is illness anxiety disorder?
Preoccupation with having a serious illness.
What are the criticisms of current medical terms regarding symptoms?
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.”
What percentage of patients in primary health care have somatisation symptoms?
20%.
What percentage of patients in specialist clinics have medically unexplained symptoms related to GIT?
53%
What percentage of patients in specialist clinics have medically unexplained symptoms related to neurology?
42%.
What percentage of patients in specialist clinics have medically unexplained symptoms related to cardiology?
32%.
hat percentage of patients with medically unexplained symptoms (MUS) have co-morbid depression, anxiety, or somatic disorder?
50%.
What are the implications of somatic symptoms on health care?
They lead to high health care consumption and impaired function.
What is central sensitization?
A condition where the central nervous system becomes hyper-responsive to stimuli, increasing pain perception.
What factors can contribute to central sensitization?
Tissue injury, psychological distress, ongoing stimuli, and influences from genetic factors.
What conditions are often associated with central sensitization?
Chronic pain conditions such as fibromyalgia and other chronic pain syndromes.
what is hyperalgesia ?
increased sensitivity to pain, where a painful stimulus feels more intense
what is allosynia ?
when a normally non-painful stimuli cause pain.
What is the role of glutamate and substance P in pain perception and central sensitization?
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
What does the biopsychosocial model encompass?
It includes biological(pain memory /prior injury), psychological, and social factors that influence health and illness.
What psychological factors are considered in the biopsychosocial model?
- Coping style
- beliefs
- expectations
What memory /prior injury related factors are included in the biopsychosocial model?
- memories about pain
- Genetic factors
What social factors are part of the biopsychosocial model?
occupation, family, and support.
Which factors contribute to central sensitization?
On going stimulus ,Genetic factors, tissue injury, and autonomic activity.
What is a key requirement for diagnosing Somatic Symptom Disorder?
One or more physical symptoms that are distressing or cause disruption in daily life.
What are the excessive thoughts, feelings, or behaviors related to in Somatic Symptom Disorder?
- Ongoing thoughts disproportionate to the seriousness of symptoms
- High levels of anxiety about health or symptoms
- Excessive time and energy spent on symptoms or health concerns
How many symptoms must be present for a diagnosis of Somatic Symptom Disorder?
At least one symptom must be constantly present, although symptoms may vary and come and go.
Where do individuals with Somatic Symptom Disorder typically seek help?
They usually go to a primary care physician rather than a psychiatrist or mental health professional.
What difficulty do individuals with Somatic Symptom Disorder often experience?
They may have trouble accepting that their concerns about their symptoms are excessive and remain fearful despite evidence of no serious condition.
What is a common dominant symptom in some individuals with Somatic Symptom Disorder?
Pain.
What are the key steps in the consultation process for managing patients with somatic symptoms?
- 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.
What is the first step in the consultation/diagnosis process?
Review of physical symptoms.
Why is it important to address and acknowledge a patient’s concerns during consultation?
It helps build trust and ensures the patient feels heard and validated.
What should be provided to the patient regarding investigations?
Feedback on investigations while acknowledging the reality of their symptoms.
What does reattribution involve in the consultation process?
Exploring the history of the patient’s symptoms.
What is crucial when using an explanatory model during consultation?
It should be appropriate for the patient.
What is the explanatory model in healthcare?
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.
What types of treatment are included in the management of patients with somatic symptoms?
Specific pharmacological treatment and psychotherapy.
How can a symptom diary be useful in management?
It helps track symptoms over time, providing valuable insights for treatment adjustments.
What therapeutic model is often utilized in managing somatic symptoms?
The Cognitive Behavioral Therapy (CBT)
What are the key components of managing patients with somatic symptoms?
- Establishing a therapeutic relationship
- ensuring regular follow-up
- implementing harm reduction strategies
- and maintaining comprehensive medical reports.
What is a key characteristic of conversion disorder?
It involves neurological symptoms that cannot be explained by medical conditions.
How is conversion disorder typically diagnosed?
Through the exclusion of other medical or neurological conditions that could explain the symptoms.
What is the primary feature of Functional Neurological Symptom Disorder?
One or more symptoms of altered voluntary motor or sensory function.
How must the symptoms of Functional Neurological Symptom Disorder be characterized?
They must be incompatible with recognized neurological or medical conditions.
What is required for a diagnosis of Functional Neurological Symptom Disorder regarding the patient’s functioning ?
The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Can the symptoms of Functional Neurological Symptom Disorder be better explained by another medical condition?
No, the symptoms cannot be better explained by another medical condition or disorder.
What is the primary characteristic of Factitious Disorder?
Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception.
What is the motivation behind the behavior in Factitious Disorder?
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 .
How must the symptoms of Factitious Disorder be presented?
The individual presents themselves as ill, impaired, or injured
What is required for a diagnosis of Factitious Disorder regarding the awareness of the deception?
The individual is aware that they are fabricating or inducing symptoms.
an Factitious Disorder be diagnosed if the symptoms are better explained by another mental disorder?
No, the symptoms must not be better explained by another mental disorder, such as a delusional disorder.
