Psychosomatization Flashcards
What is somatization?
Physical complaints or impairments without organic pathology
Is somatization a conscious or unconscious process?
Unconscious (patient cannot use emotional language to describe their distress)
What are the common psychosomatic complaints?
Chronic pain, problems with digestive system, nervous system, and reproductive system
What is the typical age of onset for psychosomatic issues?
Before age 30
What is the gender bias for pscyhosomatization?
Females
What is the neurobiological mechanism of somatization?
Defective neurobiological processing of sensory and emotional information
What is the psychodynamic mechanism of somatization?
Sensations occur as expression of underlying emotional conflict to meet latent needs for nurturing and support
What is the behavioral mechanism of somatization?
Behavior is brought about and reinforced by other in patient’s environment
What is the sociocultural mechanism of somatization?
A way to expression emotions through physical symptoms in a culture or situation that doesn’t allow direct communication of emotional content
Is somatization common?
YES; primary care docs are seeing it in up to 40% of patients
What other conditions are often seen with somatization?
Depression and anxiety
Are most somatizers aware of their psychological disorders?
No
What is the most common form of somatization?
Acute: results from transient stress that temporarily overwhelms usual coping mechanisms
What are the two subcategories of chronic somatization?
1 Somatoform disorders 2 Malingering and factitious disorders
How are factitious disorders characterized?
Physical or psychological symptoms that are intentional produced in order to assume the sick role (conscious fabrication to gain attention)
What is malingering?
Intentionally exaggerating illness or disability to derive benefit or secondary gain
Patients with which condition are likely to agree to unnecessary surgery and interventions: factitious disorder or malingering?
Factitious disorder
What motivates those with factitious disorder?
Psychological needs like attention and security
What motivates those who malinger?
Secondary gains like avoiding work
Malingering is more commonly seen with what population?
Military populations and legal settings
What is the most important aspect of managing somatizing patients?
Develop an empathic, trusting doctor-patient relationship
What is the management approach for somatizing?
CAREMD: Cognitive behavioral therapy, assess to rule out medical causes, regular visits, empathy, med-psych interface, do no harm
When educating patients involved with somatization, what connection should be stressed by the physician?
Link between stressors and the autonomic nervous system
Does the treatment of transient somatizers have a good or poor prognosis?
Good (often willing to consider psychological explanations for their issues)
