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RC Nuggets > Somatic + Culture syndromes > Flashcards

Somatic + Culture syndromes Flashcards

1
Q

Amok

A

Depression then aggression/homicidal precipitated by perceived insult.

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2
Q

Dhat

A

Attribute symptoms to lose of sperm (white substance while urinating/defecating).

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3
Q

Koro

A

Fear penis will go into abdomen and cause death.

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4
Q

Latah

A

Provoked by state of surprise, trance state, where mechanically repeat words or gestures by other.
(South East Asia)

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5
Q

Zhar

A

Possession by spirits with laughing, yelling, hitting had against wall, singing, crying.

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6
Q

Khyal

A

Wind rises in body and causes panic attack.

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7
Q

Taijin Kyofusho

A

Convinced appearance or actions are inadequate/offensive (similar to olfactive reference syndrome).

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8
Q

Sangue Dormido

A

Neurological symptoms (seizure, paralysis, blindness).

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9
Q

Defences in somatization?

A

Repression

Displacement

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10
Q

Somatic symptom disorder

A

At least one distressing symptom

At least one excessive thoughts/feelings/behaviours related:

  1. Persistent thoughts about seriousness of symptom
  2. Persistently elevated anxiety about health/symptom
  3. Excessive time/energy devoted to health concerns

Symptomatic state persists (typically more than 6 months)

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11
Q

Somatic symptom disorder specifiers

A

With predominant pain
Persistent (> 6 months)
Severity

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12
Q

What do SSRIs treat in somatic symptom disorder?

A

Mood and anxiety symptoms but DON’T HELP SOMATIC SYMPTOM

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13
Q

Somatic symptom disorder co-morbidity rate?

A

80% depression or anxiety

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14
Q

Pain disorder co-morbidities?

A

Acute more with anxiety

Chronic more with depression

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15
Q

Somatic symptom disorder treatment

A

TCA & SSRIs for pain, co-morbidities
Analgesics generally not helpful
Maximize advantages of health and minimize disadvantages
Consistent reassurance by primary care

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16
Q

Illness anxiety disorder

A

Pre-occupied with having/acquiring a serious illness
NO SOMATIC SYMPTOMS or mild

Pre-occupation clearly excessive or disproportionate (if have medical condition or risk of developing because of family history)

High anxiety and easily alarmed about personal health

Excessive health-related behaviours or maladaptive avoidance

Present for 6 months
Specific illness may change over time

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17
Q

Illness anxiety disorder specifiers

A

Care-seeking (majority)

Care-avoidant

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18
Q

Most common conversion symptoms?

A

PARALYSIS
BLINDNESS
MUTISM

19
Q

How many conversion patients will eventually get causal medical diagnosis?

A

25-50%

20
Q

Which symptoms do not correspond to conversion disorder?

A

PAIN
FATIGUE
SEX dysfunction

21
Q

Functional neurological symptom disorder (conversion disorder)

A

At least one symptom of altered voluntary motor or sensory function

Clinical evidence of incompatibility between the symptom and recognized neurological or medical conditions

22
Q

Conversion types

A 
Weakness or paralysis
Abnormal movement (tremor, gait)
Swallowing symptoms
Speech symptoms
Attacks or seizures
Anesthesia or sensory loss
Special sensory symptom
Mixed symptoms

With psychological stressor
Without psychological stressor

23
Q

Conversion disorder acute vs. persistent

A

6 month cutoff

24
Q

Which conversion types have bad prognosis?

A

Tremor

Seizure

25
Q

Which conversion types have good prognosis?

A

Paralysis
Aphonia
Blindness

(aka the most common which is good I guess…)

26
Q

Which side of brain more affected in conversion disorders in women?

A

LEFT

27
Q

Which PDs associated with conversion disorder?

A

Histrionic
ASPD
Dependent

28
Q

Risk factors for conversion disorder?

A

Rural
Low SES
Low education/IQ
MILITARY VETS

29
Q

Waddell Signs in conversion disorder?

A
  1. Sensitivity to pressure
  2. Simulated maneuvers (don’t cause pain)
  3. False maneuver
  4. Neuroanatomy
  5. Hyperreaction
30
Q

Hemianesthesia conversion finding?

A

Strict half-body split

31
Q

Atasia-abasia conversion finding?

A

Inconsistent abilities in standing, walking, dancing in a normal manner.

Atasia = inability to stand upright unassisted
Abasia = lack of motor coordination in walking
32
Q

Hoover test

A

Pressure noted in hand under paralyzed leg during antagonistic contraction

33
Q

Aphonia conversion finding?

A

CAN COUGH (cords closing)

34
Q

Blindness conversion findings?

A

Look at your hand - even blind patients can do this by proprioception

I’m testing coordination - patient mimics new movements before realizing

Sudden flash of bright light - patient flinches

35
Q

Conversion disorder treatment?

A

Reassurance
Physiotherapy
Treat co-morbidities

36
Q

What’s most likely to be associated with pseudologica fantastic with peregrinating?

A

Factitious disorder

37
Q

Difference between factitious and malingering?

A

No secondary gains in factitious

38
Q

Clues for factitious disorder?

A

Eagerness for procedures
Reluctance for collateral
Medical professional

Co-morbid with MDD

39
Q

Factitious imposed on a child results in death in what percentage?

A

6-9%!!!!!

40
Q

Most frequent methods of factitious imposed on a child?

A

Poisoning

Smothering

41
Q

Ganser syndrome?

A 
Often seen in prisoners
Non-sensical wrong answers
State of consciousness, disoriented
Somatic symptoms
Pseudohallucinations
42
Q

Malingering

A

V code in DSM-5
1% mental health
10-20% NCR evaluations

PD in adults
CD + anxiety in kids

43
Q

Factitious disorder treatment

A

Face-saving strategies:

  • self-hypnosis
  • biofeedback

GP as gatekeeper

Prompt diagnosis

RC Nuggets (20 decks)

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