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Behavioral Med 1 > Somatic Sx D/o > Flashcards

Somatic Sx D/o Flashcards

1
Q

What are somatic sx d/o characterized by? (basically, what are they?)

A

Physical sx for which no underlying medical workup can identify a cause

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2
Q

__% of primary care pts exhibit medically unexplained sxs

A

30%

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3
Q

Somatic sx d/o are more common in (men/women), with a typical age of onset in the _____ but also in the ______

A

women; 20s; elderly

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4
Q

Somatic sx d/o are more common for lower _____ and lower ______

A

income; education level

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5
Q

What is the etiology of somatic sx d/o?

A

Unknown, likely genetic component as can run in families

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6
Q

Somatic sx must be presents for how long for official dx of somatic sx d/o? Must this be the same sx or many?

A

at least 6 mo

one single sx does not have to persist that entire time “sx migration

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7
Q

T/F Somatic sx d/o can affect multiple organ systems

A

true

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8
Q

In pts with somatic sx d/o, when does the preoccupation w/ their sx usually begin? How long can their sx last for?

A

usually begins early in life

months, years, or even decades

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9
Q

What general type of sx do pts with somatic sx d/o usually present with? Examples?

A

Sxs are often those which cannot be measured, pain, GI upset, malaise, blurry vision

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10
Q

What are some clues that a pt might have a somatic sx d/o?

A

Frequent clinical visits and “doctor shopping”
Frequent/multiple admissions (ED, inpt)
Unnecessary medical procedures

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11
Q

What aspect of illness/anxiety d/o interferes w/ a pt’s normal social functioning?

A

Incessant worry

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12
Q

Are pts with illness/anxiety d/o sx d/o reassured by negative medical tests?

A

No

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13
Q

Pts with illness/anxiety d/o may amplify/misinterpret normal _________

A

physiological experiences/sensations

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14
Q

What is the distress that pts with illness/anxiety d/o suffer from caused by? What is it NOT caused by?

A

NOT from the sxs, but what they feel the sxs mean, and the resulting anxiety and concern

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15
Q

Do men have a(n) higher/lower/equal prevalence of illness/anxiety d/o as women? In what population is illness/anxiety d/o rarely seen in?

A

men and women have similar prevalence; rarely found in children

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16
Q

What are some characteristics/actions of a pt w/ illness/anxiety d/o?

A

Pts are often hypervigilant about their health, monitor their bodies frequently for dz, may insist on multiple standard screening exams

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17
Q

When illness/anxiety d/o is seen in the elderly, what is often the focus of their d/o?

A

memory-related

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18
Q

Are Conversion D/o and Functional Neurological Sx D/o the same d/o?

A

Yes

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19
Q

Pts with conversion d/o usually have 1+ sx where (involuntary/voluntary) motor/sensory fxn is lost, and suggests an underlying _______ condition

A

voluntary; neuro/medical

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20
Q

In pts with conversion d/o, sx that are described (are not/are) consistent w/ a known neuro/medical illness

A

are not

21
Q

T/F A precipitating psychological factor is not usually associated with onset of sx of a conversion d/o

A

False, it usually is, but is not required for dx

22
Q

If the pt’s main complaint is limited to pain, then they are dx w/ ________

A

Somatic Sx D/o

23
Q

In regards to conversion d/o, acute is ____ mos of sx, and chronic is _____ mos of sx

A

<6; >6

24
Q

___-___% of pts admitted to neuro service have conversion d/o

A

20-25%

25
Q

Conversion d/o is more frequent in _____, lower income/educational level, and ____ areas

A

women; rural

26
Q

When is the typical age of onset of conversion d/o?

A

onset can be anywhere from childhood to adulthood

27
Q

Many pts w/ conversion d/o have additional dx of….

A

other mental illnesses (mood or psychotic d/o)

28
Q

Are sx of conversion d/o more permanent or more come-and-go?

A

Sx are transient

29
Q

The best outcome of pts with conversion d/o is associated w/ what type of onset? In the absence of what?

A

acute onset with a clear precipitating stressor

in the absence of other comorbid neuro/medical conditions

30
Q

What are some common complaints coming from a pt with conversion d/o? (x7)

A

Paralysis, abnml movements (twitching), aphonia, blindness, deafness, pseudoseizures, loss of sensation/anesthesia over part of body

31
Q

How often are psychotropic medications needed in the tx of somatic sx d/o, illness/anxiety d/o, and conversion d/o?

A

Rarely are psychotropic meds needed, unless there is a clear co-morbid condition

32
Q

Individual psychotherapy, cognitive behavioral therapy (has not/has) shown value in tx pts with somatic sx d/o, illness/anxiety d/o, and conversion d/o

A

has

33
Q

SSRIs have been shown to improve_______ in the past in pts with somatic sx d/o, illness/anxiety d/o, and conversion d/o

A

hypochondriasis (DMS-IV dx)

34
Q

If a pt with somatic sx d/o, illness/anxiety d/o, or conversion d/o presents with c/o ______, they may need inpatient tx

A

Dramatic sx (i.e. blindness, paralysis)

35
Q

What is factitious d/o?

A

A d/o characterized by the intentional production or feigning of physical or psychological sx

36
Q

Are there any clear external factors/incentives for faking sx in a pt with factitious d/o?

A

No

37
Q

What is factitious d/o thought to be motivated by?

A

unconscious desires

38
Q

Once factitious d/o is suspected/likely, what should be immediately obtained?

A

Psych consult

39
Q

If you feel as though you have sufficient evidence to dx a pt with factitious d/o, how should you confront the pt?

A

in a non-threatening manner

Once evidence is obtained, their belongings and room can be searched (drugs, sharp objects)

40
Q

Patients with factitious d/o often have a (short and uncomplicated/lengthy and complex) medical Hx

A

lengthy and complex

41
Q

In a pt with factitious d/o, self reported signs and sx are usually described as…

A

Self-reported s/s are “textbook”

42
Q

Pts with factitious d/o usually have an extensive hx of what?

A

Hx of excessive surgeries

43
Q

Once you believe that a pt has factitious d/o, what should be done?

A

Obtain previous medical records, if possible, and speak w/ previous providers

44
Q

What is the one condition that is not technically a somatic d/o that I am lumping into this section, and is actually characterized as an “Other Conditions” d/o?

A

Malingering!

45
Q

Is malingering considered a mental d/o?

A

No

46
Q

What is malingering?

A

The act of intentionally reproduction of sx/feigning illness for specific gain

47
Q

Might might be considered “external incentives” for pts presenting with malingering?

A

missing work, monetary compensation, avoiding military obligation, obtaining drugs…

48
Q

How should pts with malingering be handled?

A

Not really sure, no consensus on this matter – good luck!

Behavioral Med 1 (8 decks)

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