Somatic Symptom And Related Disorders

Question 1

Which disorder is described by the involuntary or subconcious presence of physical symptoms causing excessive disruption and stress?

Answer 1

Somatic symptom disorder

Question 2

Which disorder is described by the involuntary or subconcious presence of neurological symptoms causing excessive disruption and stress?

Answer 2

Functional neurological or conversion disorder

Question 3

Which disorder is described by the involuntary or subconcious preoccupation with having or acquiring a seniors illness causing excessive disruption and stress?

Answer 3

Illness anxiety disorder

Question 4

Which disorder is described by falsification of physical signs or symptoms, injury or disease, associated with identified deception

Answer 4

Factitious disorder

Question 5

Which condition describes the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external gain eg avoid work, jail, obtain drugs

Answer 5

Malingering

Question 6

Time period of somatic symptom disorder

Answer 6

Symptomatic for 6 or more months

Question 7

Typical history of patients with somatic symptom disorder? (3)

Answer 7

Abuse ,
marital/interpersonal/ occupational problems
Multitude of diagnostic tests done

Question 8

Which condition describes signs and symptoms of pregnancy without the presence of a foetus?

Answer 8

Pseudocyesis

Question 9

Which condition describes psychological or behavioural factors adversely affecting a medical condition ?

Answer 9

Psychological factors affecting other medical conditions

Question 10

Malingering vs Factitious disorder?

Answer 10

Both intentional production/faking symptoms
Malingering motivated by external reward eg avoid work, money, obtain drugs
Factitious for sympathy, nurturance, attention

Question 11

Name 4 “other specified somatic symptom and related disorders”

Answer 11

• Brief somatic symptom disorder
• brief illness anxiety disorder
• illness anxiety disorder without excessive health-related behaviours
• pseudocyesis (phantom pregnancy)

Question 12

Name 3 criteria somatic symptom disorder

Answer 12

• One or more somatic symptoms that are distressing/ result in significant disruption of daily life
• excessive thoughts/ feelings /behaviours - at least 1:
  → disproportionate, persistent thoughts
  → extensive time and energy
  → anxiety
• > 6 months (may be different somatic symptoms)

Question 13

Name 5 specifiers somatic symptom disorder

Answer 13

• with predominant pain
• persistent
• mild: only 1 symptom from criteria B eg thoughts/anxiety / time + energy
• moderate: 2 or more symptoms
• severe: 2 or more + multiple somatic complaints/ 1 very severe

Question 14

Name 10 differentials for somatic symptom disorder

Answer 14

True disease

Medical Conditions with vague presentations

• neuro: ms, myasthenia gravis
• autoimmune: SLE
• metabolic: intermittent porphyria, hyperparathyroid, haemosiderosis
• infections: syphilis, HIV
• git: IBD

Mental disorders

• other somatic symptom and related disorders
• anxiety disorders: gad, panic disorder
• mood: MDD, persistent depressive disorder, dysthymia
• OCD + related: OCD, body dysmorphic disorder
• psychotic: scz, schizo affective, delusional disorder somatic type

Question 15

Duration illness anxiety disorder

Answer 15

6 months or more

Question 16

Name 2 specifiers illness anxiety disorder

Answer 16

• Care seeking type
• Care avoidant type

Question 17

Name 2 specifiers factitious disorder

Answer 17

• Single episode
• recurrent episodes

Question 18

Name 8 symptom type specifiers for conversion disorder

Answer 18

• With weakness or paralysis
• with abnormal movements
• with swallowing symptoms
• with speech symptom
• with attacks or seizures
• with anesthesia or sensory loss
• with special sensory symptom
• with mixed symptoms

Question 19

Name 2 time period specifiers for conversion disorder

Answer 19

• Acute episode: symptoms <6 months
• persistent: 6 or more months

Question 20

Name 2 psychological specifiers for conversion disorder

Answer 20

• With psychological stressor (specify stressor)
• without psychological stressor

Question 21

Name 5 criteria for psychological factors affecting other medical conditions

Answer 21

• A. Medical symptom/condition (other than mental) present
• B. Psychological or behaviour factors adversely affect medical condition by 1 of following
  → influenced course of condition shown by close temporal association between psych factors and development / exacerbation / delayed recovery
  → interfere with treatment of medical condition eg poor adherence
  → factors constitute additional, well established health risks for individual
  → factors influence underlying pathophysiology / precipitating /exacerbating symptoms or necessitating medical attention

Question 22

Name 4 specifiers for psychological factors affecting other medical conditions

Answer 22

• Mild: increase medical risk eg inconsistent adherence to treatment
• moderate: aggravate underlying condition eg anxiety aggravating asthma
• severe: result in medical hospitalization/ Er visit
• extreme: result in severe, life threatening risk eg ignore heart attack symptoms

Question 23

Which condition describes someone falsifying signs /symptoms/injury/ disease on other, presenting another individual as victim, absence of obvious external rewards

Answer 23

Factitious disorder imposed on another

Question 24

Name 7 somatic symptom and related disorders

Answer 24

• Somatic symptom disorder (6 mo)
• illness anxiety disorder
• factitious disorder
• conversion
• psychological factors affecting other medical conditions
• other specified somatic symptom and related disorder, reason
• unspecified somatic symptom and related disorder