Somatic Sx D/Os Flashcards
Process of assessing Somatization
- formation of therapeutic alliance: be curious about sx with pt’s; they are guarded
- complete a psychiatric assessment
- do physical examination
- PHQ15
Treatment of Somatic disorders-
- CBT
- SSRI
- SNRI
Name the differences in control and motivation for:
Somatic Symptom Disorders
Factitious Disorders
Malingering
Somatic Disorders (not faking at all)
- unconscious control
- unconscious motivation
Factitious Disorders (faking but doesn’t know why)
- conscious control
- unconscious motivation
Malingering (complete asshole)
- conscious control
- conscious motivation
2 parts of defining Somatic Symptom Disorder
-1 or more physical symptoms with distress or disruption
AND
-excessive thoughts, feelings, behaviors related to these symptoms
Clinical course of Somatic Symptom Disorder
- females more than males
- poor prognosis
Risk factors for Somatic Symptom Disorder
- lower educated
- stressful life events
- present “illness benefits”
- childhood abuse/neglect
Differential diagnosis of Somatic Symptom Disorder
- Schizophrenia
- Anxiety
- Depression
- Substance use disorders
Treatment of Somatic Symptom Disorder
- CARE not cure
- treat psychiatric co-morbidities
- CBT
Management with Primary Care
- schedule regular appointments to decrease emergency care
- avoid use of high risk or invasive tests
Define illness anxiety disorder
-pre-occupation and anxiety about an illness
BUT
-NO ACTUAL SYMPTOM or very insignificant symptom
-with Somatic symptom disorder, there is a significant symptom
-duration at least 6 months
Differential Dx of illness anxiety disorder
- Somatic symptom disorder
- Panic disorder
- Generalized anxiety
- OCD
- Delusional disorder
- Body dysmorphic disorder
Dx Conversion Disorder
-disorder of coping therefore symptoms are recurrent
-one or more symptoms of altered voluntary motor or sensory
-symptoms are anatomically possible
-duration of symptoms episodic
20% or more develop somatic symptom disorder
-MS is an important differential
