Somatic Symptom Disorder

Question 1

Clinical Features of Somatization (List 5)

Answer 1

Multiple symptoms
Vague symptoms 
Chronic
Comorbid psychiatric disorder
History of extensive testing 
Rejection of previous physicians

Question 2

Non pharm management (list 3)

Answer 2

Brief but frequent visits 
One physician 
Biofeedback 
Minimize investigations 
Psychotherapy
Minimize psychotropic drugs

Question 3

Definition of Illness Anxiety Disorder

Answer 3

Preoccupation with having a serious illness 
Mild/no somatic symptoms 
Preoccupation is excessive
High level of anxiety about health
Excessive health related behaviour 
Preoccupation > 6 months

Question 4

Definition of body dysmorphic disorder

Answer 4

Preoccupation with preceived defect in physical apparance
Out of proportion
Repetitive behaviours in response (grooming, mirror checking)
Causes distress

Question 5

What is conversion disorder

Answer 5

Altered voluntary motor or sensory function
Incompatilibity between physical exam and symptoms
Symptoms can’t be medically explained

Question 6

Factitious Disorder

Answer 6

Somatic complaint done consciously but for unconscious reasons (e.g. attention)
Can be imposed on another

NOT Malingering which is not somatization

Question 7

Co morbidities with Somatization

Answer 7

Anxiety
OCD
MDD
Personality disorder 
Substance abuse 
Sexual physical abuse in past

Question 8

What do do before diagnosing Somatic Symptom disorder

Answer 8

Complete history and physical exam
Appropriate work up
Appropriate referrals
Don’t assume on a SOO

Question 9

Diagnostic criteria of somatic symptom disorder

Answer 9

One or more somatic symptom that is causing clinical distress
Excessive thoughts, feeling or behaviours related to the somatic symptom
Excessive thought about it
Excessive anxeity about it
Lots of time and energy devoted to symptoms/health
>/6 mo

Symptom can change