Somatic Disorders Flashcards
Describe the evolution of somatic disorders
- Hysteria: 2,000 yrs ago by the Greeks, symptoms came from uterus
- Briquet syndrome: at least 25/60 possible symptoms
- Somatization disorder: DSM3 in 1980, new criteria that reduced number of symptoms
- Somatic Symptom Disorder: DSM5, single symptom
Define Somatic Symptom Disorder (SSD)
- Chronic condition w/unexplained physical symptoms
- Almost exclusively in women
Symptoms suggestive of SSD
- Excessive or chronic pain
- Conversion symptoms
- Chronic, multiple symps that seem to lack an adequate explanation
- Complaints that don’t improve, despite treatment that helps most pts
- Excessive concern w/health or body appearance
Essential feature of SSD
High level of health anxiety by investing excessive time in health care or being excessively worried as to the seriousness of somatic symptoms
Describe the pain a/w somatic symptom disorder
- Typically, it does NOT: wax and wane w/time, diminish w/distraction (UNLIKE DSM 4 somatization disorder)
- It may respond only poorly to analgesics if at all
Describe illness anxiety disorder
- High anxiety coupled with a low threshold for alarm
- Seek reassurance, check for physical signs over and over
- SOME pts cope by avoiding appts though
Types of illness anxiety disorder
- Care seeking type (uses medical services more than normal)
- Care avoidant type (avoids medical care)
Describe conversion disorder
- S/s seem clinically inconsistent with any known medical illness
- Normal exam or bizarre result isn’t enough to affirm diagnosis
- Change in findings from positive to negative when a different test
- Impossible findings
Essential features of factitious disorders
May look like bona fide disease, but it isn’t:
- Simulating symptoms or physical signs (warming a thermometer in coffee)
- Complaint of psych symptoms
Types of factitious disorder
- Behaviors affect that person
- Behaviors affect another individual
Describe FDIS (factitious disorder imposed on self)
Sometimes take on symptoms of new and poorly investigated illnesses (“disorder du jour”)
Describe FDIA
- Munchausen’s by proxy (believe someone else is ill, induce symptoms)
- Child is almost always the victim
- More than 75% of perpetrators are female (usually the mother)
- Many have background in medicine
Mental status exam findings of somatic symptom disorder
- Preoccupation w/physical symptoms
- Mildly anxious, depressed
- NO evidence of thought disorder
- Insight and judgment appears limited
Define conduct disorder
- A child persistently violates rules or rights of others
- Sets fires, destroys property, repeated runaways
Define conduct disorder with limited prosocial emotions
Child has disordered conduct that is callous and disruptive, shows no remorse or regard for feelings of others
