Somatic symptom disorder

Question 1

Describe DSM 5 criteria for somatic symptom disorder x5

Answer 1

A. One or more somatic symptoms causing distress or disruption in life
B. Excessive thoughts feeling behaviors about theses symptoms manifested by either
1. Disproportionate thoughts about the seriousness of the symptoms
2. Anxiety about the symptoms
3. Excess time spent thinking about the symptoms
C. Symptoms lasting for 6M+

Question 2

Describe severity of SSD x3

Answer 2

Mild- only one symptom in B is fulfilled
Moderate- symptoms in B fulfilled
Severe- 2 symptoms plus multiple somatic complaints

Question 3

Aim of CBT in SSD

Answer 3

To help patient to be able to function in the presence of somatic symptoms

Question 4

Management of SSD x4

Answer 4

Bio- reduce iatrogenic injury
Psychosocial- CBT, relaxation exercises, supportive therapy

Question 5

Define illness anxiety disorder

Answer 5

Persistent anxiety or fear of having or developing serious medical illness

Question 6

Specifiers of illness anxiety disorder x2

Answer 6

Care seeking type
Care avoidant type

Question 7

DSM5 for illness anxiety disorder x6

Answer 7

1. Preoccupation about being or getting sick
2. No symptoms or if present they are mild
3. Great anxiety or fear about health
4. Excess health related behaviors
5. Greater than 6M
6. Not explained by any other mental disorder

Question 8

Management of illness anxiety disorder x6

Answer 8

Reduce stress
Reduce iatrogenic harm
Psychoeducation
Hypnosis
Psychotherapy - CBT, psychodynamic

Question 9

What causes conversion disorder

Answer 9

Repression of unconscious intrapsychic conflict and conversion of anxiety to physical symptoms

Question 10

Distinguish between primary and secondary gain

Answer 10

Primary- intangible
Secondary- tangible advantages and benefits

Question 11

Describe identification in conversion disorder

Answer 11

Patients unconsciously model their symptoms to be those of someone important to them

Question 12

Describe le belle indifference

Answer 12

Patient seems to be unconcerned about what appears to be a major impairment

Question 13

Describe bland indifference

Answer 13

Seriously ill patients develop an emotionless stoic attitude

Question 14

DSM criteria for conversion disorder x4

Answer 14

1. One or more symptoms of altered motor or sensory function
2. Symptoms not compatible with suggested neurological or medical condition
3. Symptoms not better explained by medical or mental disorder
4. Distress and functional impairment

Question 15

Management of conversion disorder x4

Answer 15

Reassurance
Psychoeducation
Treat comorbidities eg physiotherapy
Individual or group therapy

Question 16

What is the motivation for factitious disease x2

Answer 16

To receive medical care and participate in the medical system

Question 17

DSM criteria for factitious disease x4

Answer 17

1. Falsification of symptoms
2. individual presents themselves as ill or impaired
3. Deceptive behavior present when there is no obvious external gain
4. Behavior cant be explained by any mental disorder

Question 18

Management of factitious disease x5

Answer 18

Psychoeducation
Reduce iatrogenic harm
Address underlying needs or psychiatric conditions
Supportive care and hypnosis
Mindful of legal implications

Question 19

Causes of somatic symptoms related disorders x5

Answer 19

Genetics
Culture
Personality
Learning/conditioning
Adverse childhood experiences

Question 20

Differentials for these somatoform disorders x6

Answer 20

OCD
Anxiety
Psychosis
Depression
Personality disorder
Adjustment disorder

Question 21

Psychological management of somatoform disorder x4

Answer 21

CBT
Psychoeducation
Psychodynamic
Relaxation exercises