Psychosomatic illnesses Flashcards
What is a psychosomatic illness?
real physical symptoms that arise from or are influenced by the mind and emotions rather than a specific organic cause in the body (such as injury or infection).
originates from or is aggravated by emotional stress and manifests in the body as psychogenic or physical pain and other symptoms.
Depression can also contribute to psychosomatic illness, especially when the body’s immune system has been weakened by severe and/or chronic stress.
Psychosomatic symptoms are real and require treatment just as any other illness would
What is the impact of stigma?
Socialstigmaattached to psychosomatic illness may prevent some from seeking treatment.
Stigma is also present in research and medical communities
Differentiate between psychogenic and psychosomatic pain
Psychogenic painis pain that results fromemotional stressor mental stress, or it is a result of a psychological disorder.
Psychosomatic painis pain due to a somatic illness that is either caused by or worsened by mental stress or distress.
Symptoms of a psychosomatic illness
Racing heart or increased blood pressure Muscle aches and pain Headaches Dizziness or shaking Digestive issues
Differences between the sexes with regards to psychosomatic illnesses
women often report symptoms such as fatigue (despite getting enough sleep), irritability, abdominal bloating, and changes to their menstrual periods.
Men are more likely to complain of chest pain, increased blood pressure, and changes in sex drive.
Types of stress
Positive stress: - also known aseustress, - keeps life invigorating and interesting. Negative Stress - “Bad” stress - Loss, loneliness, grief etc.
DSM 5 classification of psychosomatic illnesses
Classified under the Somatic Symptom Disorder cluster
includes the following diagnoses:
- Somatic Symptom Disorder,
- Illness Anxiety Disorder,
- Conversion Disorder (functional neurological symptom disorder),
- Psychological Factors Affecting Other - - Medical Conditions,
- Factitious Disorder,
- Other Specified Somatic Symptom And - Related Disorder,
- Unspecified Somatic Symptom And - - - Related Disorder
Common features of psychosomatic illnesses
Somatic Symptoms
Significant Distress
Impairment Of Functioning
DSM 5 criteria for diagnosis of somatic symptom disorder
A. One or more somatic symptoms that are distressing or result in significant disruption of daily life.
B. Excessive thoughts, feelings, or behaviours related to the somatic symptoms or associated health concerns as manifested by at least one of the following:
- Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
- Persistently high level of anxiety about health or symptoms.
- Excessive time and energy devoted to these symptoms or health concerns.
C. Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).
Specify if:
With predominant pain (previously pain disorder): This specifier is for individuals whose somatic symptoms predominantly involve pain.
Specify if:
- Persistent: A persistent course is characterized by severe symptoms, marked impairment, and long duration (more than 6 months).
Specify current severity:
- Mild: Only one of the symptoms specified in Criterion B is fulfilled.
Moderate: Two or more of the
- Severe: Two or more of the symptoms specified in Criterion B are fulfilled, plus there are multiple somatic complaints (or one very severe somatic symptom).
Prevalence of somatic symptom disorder
Not known
may be around 5%-7%.
expected to be higher than that of the more restrictive DSM – 4 somatization disorder (<1%) but lower than that of undifferentiated somatoform disorder(approximately 19%).
Females tend to report more somatic symptoms than males.
Differential diagnosis
Other medical conditions Panic disorder Generalized anxiety disorder Depressive disorders Illness anxiety disorder Conversion Disorder Delusional disorder Body dysmorphic disorder Obsessive-compulsive disorder
DSM 5 criteria for illness anxiety disorder
A. Preoccupation with having or acquiring a serious illness.
B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g., strong family history is present), the preoccupation is clearly excessive or disproportionate.
C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.
D. The individual performs excessive health-related behaviors (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doctor appointments and hospitals).
E. Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time.
F. The illness-related preoccupation is not better explained by another mental disorder, such as somatic symptom disorder, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder, somatic type.
Specify whether:
- Care-seeking type: Medical care, including physician visits or undergoing tests and procedures, is frequently used.
- Care-avoidant type: Medical care is rarely used.
Prevalence of anxiety disorder
The 1- to 2-year prevalence ranges from 1.3% to 10%.
Similar prevalence in males and females.
Differential diagnosis for anxiety disorders
Other medical conditions Adjustment Disorder Somatic symptom disorder Obsessive-Compulsive and related disorders Major depressive disorders Psychotic disorders
Conversion disorder (functional neurological disorder) DSM 5 criteria
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.
Specify symptom type:
- (F44.4) With wealcness or paralysis
- (F44.4) With abnormal movement (e.g., tremor, dystonie movement, myoclonus, gait disorder)
- (F44.4) With swallowing symptoms
- (F44.4) With speech symptom (e.g., dysphonia, slurred speech)
- (F44.5) With attacks or seizures
- (F44.6) With anesthesia or sensory loss
- (F44.6) With special sensory symptom (e.g., visual, olfactory, or hearing disturbance)
- (F44.7) With mixed symptoms
Specify if:
- Acute episode; Symptoms present for less than 6 months.
Persistent: Symptoms occurring for 6 months or more.
Specify if:
- With psychological stressor (specify stressor)
- Without psychological stressor
