Somatic Disorders Flashcards
somatic symptoms (general)
- physical symptoms that are INCOMPATIBLE with a neurological or general medical condition
- symptoms are NOT produced voluntarily
- high utilization of medical services
- resist being seen by psychiatrists
- NOT EXPLAINED BY A MEDICAL CONDITION (dx of exclusion)
somatization
- culturally acceptable form of psychosocial stress
- somatizers have a lower threshold for reporting sx
- puts ppl at risk for iatrogenic morbidity
somatic symptom disorders kept in the new DSM-V
- somatic symptom disorder
- illness anxiety disorder
- conversion disorder
- factitious disorder
- body dysmorphic disorder
somatic symptom disorders not used anymore (DSM-IV)
- somatization disorder
- pain disorder
- hypochondriasis
- somatoform NOS
- undifferentiated somatoform
NOT USED ANYMORE
lack of medically explained symptoms ___________
lack of medically explained symptoms DO NOT EQUAL A PSYCHIATRIC DIAGNOSIS
somatic symptom disorder (SSD) key criteria
1) one+ distressing somatic symptoms that cause major daily life disruptions
2) excessive thoughts, feelings, or behaviors about these sx, characterized by at least 1 of the following:
- persistent high anxiety about health/sx
- disproportionate/persistent thoughts of seriousness of sx
- excessive time/energy devoted to sx
3) time: > 6 months
illness anxiety disorder (IAD) key criteria
1) preocupation with having a serious illness
2) somatic sx are not present (or mild)
3) high level of anxiety about health, easily alarmed by personal health status
4) excessive health related behaviors or maladaptive avoidance
5) >6 months (but feared illness may change over time)
conversion disorder (CD) key criteria
- requires clear evidence of incompatibility with neurological disease
1) 1+ sx of altered voluntary or sensory function
2) evidence of incompatibility btwn sx and neurological/medical conditions
3) not better explained
4) causes significant distress/impairment
ACUTE: <6 mos
CHRONIC >6 mos
acute vs chronic CD
CD = conversion disorder
acute: < 6 mos
chronic: >6 mos
30% of pts diagnosed with ___________ eventually develop organic condition that explains conversion sx
30% of pts diagnosed with CONVERSION DISORDER eventually develop organic condition that explains conversion sx
neurologic disorders misdiagnosed as conversion disorder
- MS
- myasthenia gravis
- dystonia
psychological factors affecting other medical conditions (PFAOMC)
1) a medical sx or condition must be present
2) psychological or behavioral factors adversely affect the medical condition (influence the course, or interfere w the treatment, or add additional health risks, or exacerbate the sx)
3) not better explained by another mental disorder (PTSD, panic disorder, MDD)
PFAOMC severity criteria
Mild
-increases medical risk inconsistent coherence
Moderate
-aggravates medical condition, anxiety, asthma
Severe
-results in ED or hospital admission
Extreme
-results in severe life threatening risk
examples of PFAOMC
- long term work stress and hypertension
- anxiety and asthma
- depression and CAD
- alcohol use d/o and liver disease
- smoking and COPD
- obesity and diabetes
body dismorphic disorder (BDD) key criteria
1) preoccupation with 1+ flaws NOT observable to others
2) causes clinically significant distress or impairment
3) perform repetitive behaviors or mental acts (compare self to others)
4) not better explained concern w/ body weight that meet criteria for eating disorder
