Somatic Disorders Flashcards
What is somatization?
physical complaints without demonstrable physical findings
How do the physical symptoms of patients exhibiting somatization present?
distress and disability is out of proportion to what would be expected
Who is the most common patient presenting with somatic symptom disorder?
<30yo female from rural area, lower SES and less educated
What often missed comorbidity can be seen with somatic symptom disorder?
depression
What is alexithymia?
can’t describe their feeling in words
What are some of the most common somatization symptoms
nervousness, back pain, weakness, joint pain, dizziness, extremity pain, fatigue, nausea, headache….
What is malingering?
patient fakes illness but the potential rewards are obvious (time off work)
–prisoners, soldiers
What is illness anxiety disorder (hypochondriasis)
preoccupation with having or acquiring a serious illness, often absent of symptoms
-generally has one preoccupation at a time
What is generally the primary concern of a hypochondriac?
idea of being ill
How long does preoccupation with a certain illness usually last in hypochondriasis?
6 months
What is conversion disorder?
Symptoms typically appear neurological, but they do not follow known neuronal pathways
Are the symptoms in conversion disorder conscious or unconscious?
unconsciously feigned, not pretending
What is usually the cause of conversion disorder?
overwhelming stress (funeral)
What is the phenomenon of conversion?
psychologic problems are being “converted” into medical complaints which can manifest as pseudo-seizures and paralysis
How is conversion disorder treated?
It is best to avoid invasive procedures.
Must explain to pt that there is no serious disease, but this is how body is dealing with stress
-hypnosis, family counseling, CBT, physical therapy
What is factitious disorder?
pt fakes illness with primary goal of getting admitted to the hospital
Are the symptoms in conversion disorder conscious or unconscious?
conscious
What is Muenchausen’s by proxy?
when a person imposes feigned an illness of another
i.e.: mom causes child to have seizures
What type of history do many somatization patients have?
history chaotic life circumstances or physical abuse
What is body dysmorphic disorder?
obsession with imagined defect of face or body and compulsion to do something about it
M=F
What are some characteristics of pts with body dysmorphic disorder?
- frequent clients of plastic surgeons
- consumers of recreational surgery
- usually dissatisfied with results
- often start lawsuits
- usually have low self esteem
How are somatoform disorders treated?
CBT!!
- adjunct therapy: meditation, aerobic exercise, relaxation
- TCAs may relieve functional symptoms
