Somatic Disorders

Question 1

List the risk factors for somatic symptom disorder

Answer 1

• negative affectivity
• lower level of education
• stressful life events
• childhood adversity
• history of sexual abuse
• re-enforcing social behaviour as illness benefits
• concurrent physical or psychiatric illness

Question 2

List the criteria for somatic symptom disorder

Answer 2

> =1 somatic symptom cause distress and impairement
Excessive thoughts, feelings or behaviour related to symptoms characterized by >=1
- disproportionate and persistent thoughts about seriousness
- persistent high level anxiety
- excessive time and energy devoted to symptoms
Persistent >=6 months

Question 3

List the risk factors for illness anxiety disorder

Answer 3

Risks

• childhood illness
• childhood abuse
• psychiatric disorder

Question 4

List the criteria for illness anxiety disorder

Answer 4

Disproportionate preoccupation with having or acquiring serious illness lasting >=6 months
Somatic symptoms not present or mild
High level of anxiety about health and easily alarmed
Excessive health-related behaviour or maladaptive avoidance
Psychiatric disorder ruled out

Question 5

List the criteria for conversion disorder

Answer 5

> =1 neurological symptoms of altered voluntary motor or sensory function which cause distress, impair functioning or warrant investigation
Neurological symptom cannot be explained medically
No other illness

Question 6

List the specifiers of conversion disorder

Answer 6

• Weakness or paralysis
• Abnormal movement
• Swallowing symptoms
• Speech symptoms
• Attacks or seizures
• Anesthesia or sensory loss
• special sensory symptoms
• mixed symptoms

Question 7

List the critieria for psychological factors affecting other medical conditions

Answer 7

True medical condition present
Psychological or behavioural factors adversely affect medical condition in 1 of following way:
- change course of condition
- interfere with treatment
- constitute additional risk
- influence underlying pathophysiology
Specifiers
- midl: non-adherence to medication
- moderate: aggrevate condition
- severe: result in hospitalization
- extreme: life-threatening event

Question 8

List the criteria for factitious disorder

Answer 8

Falsification of physical or psychological signs or symptoms OR induction of injury or disease for deception
Present self or other as ill or injured
Deceptive behaviour is evident

Malingering
- motivated by external factors

Question 9

Discuss the management of somatic disorders

Answer 9

Doctor-Patient Relationship
- rule out or treat
Acute Somatization Support
- reassurance and provide support/information
Chronic Somatization Support
- under the care of 1 primary physician
- appointments limited to regular intervals with brief examinations
- avoid over-investigation/referring

Somatic Symptom Disorder

• CBT
• Relaxation
• Increase meaningful activities and exercise
• TCA, SSRI possibly