SOMATIC SYMPTOM AND RELATED DISORDERS; NONADHERENCE TO MEDICAL TREAMENT

Question 1

what is the presentation of somatic symptom disorder

aka somatization disorder

Answer 1

many unexplained pysical symptoms affecting many organ systems

Question 3

what is the presentation of functional neurological symptom disorder (conversion disorder)

Answer 3

neurologic complaints inconsistent with neurologic disease

Question 4

what is the presentation of illness anxiety disorder

aka hypochondriasis

Answer 4

persistent belief that paient has a serious illness

Question 5

what is the presentation of body dysmorphic disorder

Answer 5

false beief or exaggerated perception that a body part is grotesque or defective

Question 6

what is the presentation of somatic symptom disorder with predominent pain

aka pain disorder

Answer 6

pain that is soley related to or severely exacerbated by psychological factors

Question 7

What is the diagnostic criteria for somatic symptom disorder

Answer 7

• 1+ somatic symptom that causes distress/significant disruption of daily life secondary to anxiety, persistent thoughts, or lots of energy spent.
• > 6 months

Question 8

what is the treatment for somatic symptom disorder

Answer 8

• coordinate with ONE PCP.
• psychotherapy

Question 9

what is the diagnostic criteria for functional neurologic symptom disorder

aka conversion disorder

Answer 9

• 1+ symptoms affecting voluntary motor or sensory function that are incompatable with neurologic disease
• “acute episode” = <6 months
• “persistent episode” = >6 months

Question 10

what might you see on PE for conversion disorder

aka functional neurological symptom disorder

Answer 10

• inconsistency/incongruency with symptoms
• ex: hoovers sign (weakness with hip extension but strong with contralateral leg is flexed)
• ex: normal DTRs in a patient with a “paralyzed arm”

Question 11

what is the tx for functional neurologic symptom disorder

aka conversion disorder

Answer 11

• education about symptoms
• psychotherapy
• often resolves spontaneously

Question 12

what is the diagnostic criteria for illness anxiety disorder

previously called hypochondriasis

Answer 12

• bascially preoccupation with having an illness when NO somatic symptoms are present. High anxiety.
• symptoms >6 months

Question 13

what is the treatment for illness anxiety disorder

Answer 13

• frequent regular visits to assure patient that they are not being abandoned
• education on diagnosis
• therapy if willing to go

Question 14

what is the diagnostic criteria of body dysmorphic disorder

Answer 14

• preoccupation with 1+ percieved defect/flaw in physical appearance
• repetitive behaviors/mental acts related to concern

Question 15

what is the treatment of body dysmorphic disorder

Answer 15

• SSRIs considered first line but are off label
• psychotherapy

Question 16

what is the diagnostic criteria for somatic symptom disorder with predominant pain

aka pain disorder

Answer 16

• 1+ somatic symptom with predominant pain
• > 6 months

Question 17

what is the treatment for somatic symptom disorder with predominant pain

aka pain disorder

Answer 17

• alleviation of underlying psych symptoms
• NSAIDs first line for analgesics

Question 18

what is factitious disorder

Answer 18

intentionally faking symptoms to assume patient role

Question 19

what is the treatment for factitious disorder

Answer 19

• single provider
• psychotherapy
• call the cops if its by proxy

Question 20

what is malingering

Answer 20

intentional faking of s/s for personal gain