somatic disorders

Question 1

clinical features of somatic symptom disorder

Answer 1

-evidence that severe disorder not present does not dissuade patient
-disease presentation may change over time
-if actual disorder present, anxiety is clearly excessive

Question 2

clinical features of illness anxiety disorder

Answer 2

-belief they have serious illness despite evidence to the contrary
-disease presentation may change over time
-preoccupation interferes with relationships and occupational functioning
-few to none somatic complaints

Question 3

clinical features of conversion disorder

Answer 3

-presents with neurological symptoms that are motor or sensory but incompatible with any known neurological disorder

Question 4

what often preceded conversion disorder

Answer 4

stressors associated with psychological factors

Question 5

diagnostic criteria for somatic symptom disorder

Answer 5

-1+ somatic complaint causing significant distress/functional impairment
-anxiety or preoccupation with symptoms
-symptoms present for at least 6 months

Question 6

diagnostic criteria for illness anxiety disorder

Answer 6

-preoccupation with false belief of having or getting serious illness
-few to no somatic complaints

Question 7

diagnostic criteria for conversion disorder

Answer 7

acute loss/alteration in motor or sensory function inconsistent with any neurological disease

Question 8

what is a common manifestation of conversion disorder

Answer 8

non-epileptic seizures

Question 9

what is one way to distinguish non-epileptic from epileptic seizures

Answer 9

epileptic has postictal rise in prolactin levels

Question 10

primary gain

Answer 10

acheived by keeping internal conflicts out of conscious awareness. Symptoms represent an unconscious psychological conflict

Question 11

secondary gain

Answer 11

patient receives tangible advantages from being sick

Question 12

identification

Answer 12

bereaved person may take on symptoms experienced by deceased

Question 13

pseudologia fantastica

Answer 13

mixing limited factual information with colorful/extensive fantasies in factitious disorder

Question 14

predisposing factors for factitious disorder

Answer 14

-severe illness as a child
-grudge against medical system
-employment in healthcare
-significant past relationship with physician

Question 15

what is the differentiating factor between somatic symptom disorder and conversion disorder

Answer 15

conversion disorder requires that symptoms are incompatible with any known neurologic disorder

Question 16

most common personality disorders that are comorbid with somatic disorders

Answer 16

histrionic
dependent
antisocial

Question 17

first line treatment for all somatic disorders

Answer 17

CBT

Question 18

modest initial goals in treatment of somatic symptom disorder

Answer 18

-decrease frequency of medical visits
-commit to single PCP
-avoid unnecessary tests/procedures

Question 19

what are some possible physical recommendations in the treatment of somatic symptom disorder

Answer 19

yoga
exercise
meditation
massage

Question 20

medications for somatic symptom disorder

Answer 20

generally avoid unless comorbidities need treated

Question 21

possible CBT methods that may be helpful in treating illness anxiety disorder

Answer 21

mindfulness training
exposure therapy
acceptance and commitment therapy

Question 22

medication in the treatment of illness anxiety disorder

Answer 22

may be responsive to fluoxetine in addition to CBT

Question 23

focus of behavioral interventions in treatment of conversion disorder

Answer 23

Improving:
-self-esteem
-capacity for emotional expression and assertiveness
-ability to communicate comfortable with others

Question 24

what may be necessary for the treatment of chronic conversion disorder

Answer 24

PT

Question 25

therapeutic intervention for psychological factors affecting other medical conditions

Answer 25

psychoeducation to clarify role psychological factors can have on disease state, course, and remission

Question 26

focus of treatment in factitious disorder

Answer 26

management rather than cure

Question 27

4 goals of treatment for factitious disorder

Answer 27

-reduce risk of morbidity/mortality
-address underlying emotional needs
-address and underlying psych dx
-be mindful of legal/ethical issues

Question 28

etiology for conversion disorder according to behavioral theory

Answer 28

faulty childhood learning used with maladaptive behavioral responses for secondary gains and control of interpersonal relationships

Question 29

etiology of conversion disorder according to psychoanalytic theory

Answer 29

primary gain of psychological conflict resolution through partial expression of conflict w/o conscious awareness of its significance

Question 30

2 factors that underly most cases of factitious disorder

Answer 30

affinity for medical system
poor maladaptive coping skills