Somatic Symptom and Related Disorders; Nonadherence to Medical Treatment Flashcards
what are the 3 somatic symptom related disorders
factitious d.o
illness anxiety d.o (hypochondriasis)
somatic symptom d.o
patient consciously reports false sx, or induces sx, with the goal of playing the “sick” role
factitious d.o
key point regarding the motivation of pt w. factitious d.o
they are not movitvated by reward
factitious d.o imposed on self
munchausen syndrome
factitious d.o imposed on another person
munchausen syndrome by proxy
tx for factitious d.o
-conjoint confrontation by PCP and psychiatrist
management of factitious d.o by proxy
child must be removed by CPS
obsession w. the idea of having a serious but undiagnosed medical condition
illness anxiety d.o (hypochondriasis)
dsm 5 for illness anxiety d.o (hypochondriasis)
pt is worried about having/developing serious illness
AND
-preoccupation is present for at least 6 mo
-not better explained by another d.o (ex OCD, SSD)
tx for illness anxiety d.o (hypochondriasis)
-group/insight oriented therapy
-regular apt’s w. provider for reassurance
-SSRIs
when would you use SSRI’s for illness anxiety d.o
if concurrent/underlying anxiety or mdd
preoccupation w. having a serious illness
somatic symptom d.o
dsm 5 for ssd
-more than 1 somatic symptoms which are distressing to the pt or lead to a significant amt of disruption in the pt’s daily life
-excessive thoughts, feelings, and behaviors in relation to somatic sx and health concerns
-somatic sx must be persistent for 6 mo or more
t/f: for dx of somatic sx d.o, somatic symptoms must be constantly present for 6 months or more
f!
they don’t need to be present constantly
tx for somatic symptom d.o (3)
-have a single clinician as designated PCP
-schedule monthly visits and CBT
-avoid unnecessary diagnostic testing
