Somatic/Dissociative disorders Flashcards
what does dissociate mean?
split off consciousness to somewhere else
somatic symptoms and related disorders: _________ symptoms without a ____________ basis
physical symptoms without a physiological cause
do people with somatic symptoms have a medical cause?
not always, they either don’t have a medical cause with physical symptoms or do have a medical cause but their symptoms are extreme to what they should be for the condition
somatic sxs disorder are often acute or chronic type of disorder?
chronic
5 somatic sxs or related disorders
1) . Somatic Symptom Disorder
2) . Conversion Disorder
3) . Illness Anxiety Disorder
4) . Psychological Factors Affecting Other Medical Conditions
5) . Factitious Disorder
what is the criteria for the state of being symptomatic for a patient diagnosed with somatic symptom disorder?
state of being symptomatic has to be persistent (more than 6 months)
somatic sxs: males or females more?
females
somatic sxs and related disorders: comorbid mostly with what two other disorders?
anxiety and depressive disorders
4 criteria for somatic symptom disorder?
1) . 1 or more somatic symptom that is distressing or disrupts daily life- PT BELIEVES ILLNESS
2) . excessive thoughts, feelings or behaviors related to the symptom, manifested by disproportionate thought regarding seriousness, high level of anxiety OR excessive energy devoted to it
3) . frequently see providers and seek tx
4) . state of symptomatic is persistent (greater than 6 months)
conversion disorder onset
reported throughout the lifespan
conversion disorder: more common in males or females?
2-3x more common in females
what type of psych disorder is more common in individuals with conversion disorder than in the general population?
personality disorders
conversion disorder mimics what type of disorder?
neurological- numbness, tingling, vision problems
4 criteria for conversion disorder
1). 1 or more symptoms of altered voluntary motor or sensory function
2). incompatibility between the symptom and the neuro/medical condition
3). symptom not better explained by another disorder
4). causes significant distress
PT DOES NOT FAKE SYMPTOM
1st line tx for somatic symptom DO
regularly scheduled visits to healthcare provider
specifiers for conversion disorder (7)
1) . weakness/paralysis
2) . abnormal movement- dystonic movement, gait disorder, tremor
3) . swallowing symptoms
4) . speech symptoms (dysphonia, slurred speech)
5) . attacks or seizures
6) . anesthesia or sensory loss
7) . special sensory symptoms (visual, olfactory, hearing)
what is illness anxiety disorder?
preoccupation with having or acquiring a serious illness despite medical workups showing no disease
is illness anxiety disorder chronic or acute?
usually chronic and relapsing condition
6 criteria for illness anxiety disorder
1) . preoccupation with having or acquiring a serious illness
2) . somatic symptoms are not present
3) . high level of anxiety
4) . performs excessive health-related behaviors or avoidance
5) . present for at least 6 months
6) . not better explained by another disorder
what is the essential feature of “psychological factor affecting other medical conditions”
presence of one or more clinically significant psychological or behavioral factors that adversely affect a medical condition by increasing the risk for suffering, death, disability
what are some examples of psychological or behavioral factors for the “psychological factor affecting other medical conditions” disorder?
psychological distress, coping styles, maladaptive health behaviors (poor adherence):
i.e. anxiety affecting asthma, chronic occupational stress increasing risk for HTN, nonadherence to insulin affecting diabetes
what is the key with diagnosis for “psychological factor affecting other medical conditions” disorder?
if two distinct disorders, then diagnose both
3 criteria for “psychological factor affecting other medical conditions” disorder
1) . medical symptom or condition is PRESENT
2) . psych or behavioral factors adversely affect the medical condition by influencing the course of the medical condition, interfering with tx, constitute health risks OR influence underlying pathophys
3) . The factors in 2 are not better explained by another mental disorder
two categories of factitious disorder
imposed on self or imposed on another (Munchausen’s by proxy)
if personal gain is present within factitious disorder, what do you suspect?
malingering- exaggerate or feign illness to escape duty or work
4 criteria of factitious disorder
1) . falsification of physical or psych signs, associated with identified deception FOR PRIMARY GAIN
2) . presents oneself to others as ill, injured, or impaired, may even injure oneself
3) . deceptive behavior is evidenced even in the absence of obvious external rewards
4) . not better explained by another disorder
tx for conversion DO
patient education about the illness is FIRST LINE
CBT w or w/o PT
tx for illness anxiety DO
regularly scheduled Drs appts and then CBT
tx for factitious DO
collect info from medical providers and family to prevent unnecessary tests
what is malingering
intentional falsification or exaggeration of signs and symptoms of a medical/psych illness for SEC ONDARY GAIN (money, food, shelter, school, work)
