Somatic Disorders, Vertrees

Question 1

What is a somatic Sx anre related disorders

Answer 1

physical sx that defy medical investigation

Question 2

what are the somatic Sx and related disorders

Answer 2

somatic Sx disorder
illness anxiety disorder
conversion disorder

Question 3

somatic sx disorder

Answer 3

one+ somatic Sx that is distressing or disruptive
excessibe thoughts, feelings or behaviors related to it:
persistent thoughts about seriousness
persistent high anxiety about health
excessive time and E devoted to Sx

Question 4

definition of persistence in relation to Sx

Answer 4

at least 6 mo

Question 5

causes of somatic Sx disorder

Answer 5

health concerns
not reassured for long
utlizie excessive amounts of care
preoccupation with Sx starts early and often spans many years

Question 6

illness anxiety disorder

Answer 6

preoccupation with having serious disease
no somatic Sx
easily alarmed
not reassured
avoid or excessive health related behaciors

Question 7

duration of illness anxiety disroder

Answer 7

6+ mo

Question 8

management somatic Sx and illness anxiety disorder

Answer 8

may remit
legitimize suffering
protect form iatrogenic harm
reinforce patient physician relationship
best managed in primary care setting

Question 9

conversion disorder/Dx

Answer 9

illness of voluntary motor or sensory Sx
not intentionally produced (unconscious)
incompaticle with recognized conditions

Question 10

precipitant for conversion disorder attack

Answer 10

emotion

Question 11

ratio M:f conversion disorder

Answer 11

F:M 5:1

Question 12

la belle indifference

Answer 12

conversion disorder

Question 13

management of conversion disorder

Answer 13

spontaneous remission common for acute presentation
suggestion/hypnosis and benzos (short term)
behavior modification for persistent presentations

Question 14

types of factitious disorder

Answer 14

imposed on self

imposed on another (Munchausens by proxy)

Question 15

what are factitious disorders

Answer 15

conscious production of signs, Sx, diseases

want to be patient!! “primary gain”

Question 16

what is secondary gain

Answer 16

seek medical care for tangible life benefits ($$)

Question 17

effort vs motivation consciousness in factitious disorders

Answer 17

conscious effort

unconscious motivation

Question 18

physical and psychological Sx factitious disorder

Answer 18

socially conforming young females in higher socioeconomic class
intelligen and educated
assoc with personality disorder likely

Question 19

munchausans factitious disorder

Answer 19

triad: fabrication of disease, shifting complaints, intense frequenting different hospitals
men, lower socioeconomics
socially maladjusted
avg age 30

Question 20

munchausans by proxy

Answer 20

mother or daughter

usually imposed on child or elderly

Question 21

common Sx of factitious disorder

Answer 21

intestinal bleeding
hematuria
fever
diarrhea
hypoglycemia
cancer
non epileptic seizures
irone deficiency anemia
renal stones

Question 22

mangement factitious disorder

Answer 22

confrontation
emphasize degree of emotional distress
emphasize behavior must reflect difficulty in communicating needs
prognosis poor

Question 23

malingering

Answer 23

intentional production of illness

motivated by money, avoidance military, avoidance criminal prosecution, obtaining drugs, obtain shelter

Question 24

presentation malingering

Answer 24

male
medicolegal presentation
disparity between disability/objective findings
lack of cooperation with eval/Tx
assoc with antisocial personality disorder

Question 25

management for malingering

Answer 25

not known

Question 26

management for malingering

Answer 26

not known

Question 27

mechanism and motivation consciousness for somatic Sx, illness anxiety and conversions

Answer 27

unconscious mechanism

unconscious motivation

Question 28

consciousness for mech and motivation factitious

Answer 28

mechanism conscious

motivation unconscious

Question 29

consciousness for mech and motivation malingering

Answer 29

both conscious

Question 30

rec Tx for factitious

Answer 30

supportive therapy

Question 31

conversion more common in M or F

Answer 31

F

Question 32

in M conversion more common

Answer 32

in combat veterans

Question 33

plans for conversion Tx

Answer 33

relaxation, do nothing