Psychosomatization

Question 1

What is somatization?

Answer 1

Physical complaints or impairments without organic pathology

Question 2

Is somatization a conscious or unconscious process?

Answer 2

Unconscious (patient cannot use emotional language to describe their distress)

Question 3

What are the common psychosomatic complaints?

Answer 3

Chronic pain, problems with digestive system, nervous system, and reproductive system

Question 4

What is the typical age of onset for psychosomatic issues?

Answer 4

Before age 30

Question 5

What is the gender bias for pscyhosomatization?

Answer 5

Females

Question 6

What is the neurobiological mechanism of somatization?

Answer 6

Defective neurobiological processing of sensory and emotional information

Question 7

What is the psychodynamic mechanism of somatization?

Answer 7

Sensations occur as expression of underlying emotional conflict to meet latent needs for nurturing and support

Question 8

What is the behavioral mechanism of somatization?

Answer 8

Behavior is brought about and reinforced by other in patient’s environment

Question 9

What is the sociocultural mechanism of somatization?

Answer 9

A way to expression emotions through physical symptoms in a culture or situation that doesn’t allow direct communication of emotional content

Question 10

Is somatization common?

Answer 10

YES; primary care docs are seeing it in up to 40% of patients

Question 11

What other conditions are often seen with somatization?

Answer 11

Depression and anxiety

Question 12

Are most somatizers aware of their psychological disorders?

Answer 12

No

Question 13

What is the most common form of somatization?

Answer 13

Acute: results from transient stress that temporarily overwhelms usual coping mechanisms

Question 14

What are the two subcategories of chronic somatization?

Answer 14

1 Somatoform disorders 2 Malingering and factitious disorders

Question 15

How are factitious disorders characterized?

Answer 15

Physical or psychological symptoms that are intentional produced in order to assume the sick role (conscious fabrication to gain attention)

Question 16

What is malingering?

Answer 16

Intentionally exaggerating illness or disability to derive benefit or secondary gain

Question 17

Patients with which condition are likely to agree to unnecessary surgery and interventions: factitious disorder or malingering?

Answer 17

Factitious disorder

Question 18

What motivates those with factitious disorder?

Answer 18

Psychological needs like attention and security

Question 19

What motivates those who malinger?

Answer 19

Secondary gains like avoiding work

Question 20

Malingering is more commonly seen with what population?

Answer 20

Military populations and legal settings

Question 21

What is the most important aspect of managing somatizing patients?

Answer 21

Develop an empathic, trusting doctor-patient relationship

Question 22

What is the management approach for somatizing?

Answer 22

CAREMD: Cognitive behavioral therapy, assess to rule out medical causes, regular visits, empathy, med-psych interface, do no harm

Question 23

When educating patients involved with somatization, what connection should be stressed by the physician?

Answer 23

Link between stressors and the autonomic nervous system

Question 24

Does the treatment of transient somatizers have a good or poor prognosis?

Answer 24

Good (often willing to consider psychological explanations for their issues)