Somatic sx

Question 1

Factitious d/o
Path:
Pt:
Dx:
Tx:

Answer 1

Path:
Formerly Münchhausen Syndrome
Deceptive and falsified sx w/ no apparent external gain to the patient

Pt:
Feigned illness without any obvious external reward
Pathological lying with frequently repeated behavior
Seek medical attention frequently and seek care from numerous physicians

Dx:
No external incentives
Hx of multiple hospital admissions
Willingness to undergo procedures

Tx:
First line: psychotherapy
Tx managed best by 1 medical provider

Question 2

Somatic sx d/o
Pt:
Dx:
Tx:

Answer 2

Pt:
Vague complaints that are inconsistent
Anxiety over potential health conditions

Dx:
Screen with somatic symptom scale-8
>6m being preoccupied w/ misinterpreted bodily symptoms, which causes distress or impairment

Tx:

• Scheduling regular outpatient visits regardless of sx
• Referral for psychiatric evaluation
• Very low dose antidepressant meds

Question 3

Conversion d/o

Answer 3

Voluntary alteration of motor or sensory function that is incompatible w/ known medical conditions

Question 4

Malingering d/o

Answer 4

Secondary gain associated w/ report of sxs (time off from work, monetary reward)

Question 5

Illness anxiety d/o
Pt:
Tx:

Answer 5

Pt:

• Hypochondriasis
• preoccupation w/ having or acquiring a serious, undiagnosed illness
• Substantial anxiety about their health
• Low threshold for becoming alarmed about their health
• Maladaptive avoidance of situations or activities that are thought to represent a health threat

Tx:
CBT
Psychotherapy
Antidepressants