Somatic Symptom and Related Disorders

Question 1

Somatic Symptom Disorder

Answer 1

essential feature is the presence of one or more somatic symptoms that cause distress or a significant disruption in daily life accompanied by excessive thoughts, feelings, or behaviors related to the symptoms as manifested by at least one of the following:

• persistent and disproportionate thoughts about the seriousness of the symptoms
• persistently high level of anxiety about one’s health or symptoms
• excessive time and energy devoted to health concerns or symptoms

disorder is persistent (usually more than six months), although any one symptom may not be continuously present

Question 2

Illness Anxiety Disorder

Answer 2

characterized by a preoccupation with having a serious illness, an absence of somatic symptoms or the presence of mild somatic symptoms, a high level of anxiety about one’s health, and performance of excessive health-related behaviors or maladaptive avoidance of doctors, hospitals, etc.

preoccupation has been present for at least 6 months, although the specific illness that is of concern may change over time

Question 3

Conversion Disorder

Answer 3

a diagnosis requires the presence of symptoms that involve disturbances in voluntary motor or sensory functioning and suggest a serious neurological or other medical condition (paralysis, seizures, blindness, loss of pain sensation) with evidence of an incompatibility between the symptom and recognized neurological or medical conditions

Question 4

Factitious Disorder

Answer 4

Factitious Disorder Imposed on Self- falsify physical or psychological symptoms that are associated with their deception; present themselves to others as being ill or impaired; and engage in deceptive behavior even in the absence of an obvious external reward for doing so

Factitious Disorder Imposed by Another- falsify physical or psychological symptoms in another person, present that person to others as being ill or impaired, and engage in the deceptive behavior even in the absence of an external reward

for both types, falsification of symptoms can involve feigning, exaggeration, simulation, or induction

Question 5

Malingering

Answer 5

characterized by the intentional production of physical or psychological symptoms for the purpose of obtaining an external reward such as avoiding work, receiving financial compensation, or obtaining drugs

should be considered when the person is seeking a medical evaluation for legal reasons, there is a marked discrepancy between the person’s symptoms and objective findings, the person does not cooperate with the diagnostic evaluation or prescribed treatment, and/or the person has Antisocial Personality Disorder

Question 6

Treatment of Factitious Disorder

Answer 6

rarely seek psychotherapy on their own but, instead, do so at the urging of family members or as part of a court-ordered treatment

experts agree that establishing a good therapeutic relationship and providing supportive therapy and constancy of care is the best way to manage its symptoms