Somatic Symptom Disorder

Question 1

Somatic sx and related disorders characteristics

Answer 1

physical sx are incompatible with a neurological or general medical condition

sx are not produced voluntarily as opposed to factious d/o or malingering

sx not conscious to pt

NO secondary conscious gain

high utilization of medical services, often with limited reassurance to patients

many best treated in PRIMARY CARE w/ psychiatric support

Question 2

somatization puts ppl at risk for

Answer 2

iatrogenic morbidity

Question 3

somatic sx disorders must not be better/fully explained by

Answer 3

a medical condition, substance use, another mental disorder

somatic sx disorder=dx of exclusion

Question 4

somatic sx disorder diagnoses

Answer 4

conversion disorder

body dysmorphic disorder

Question 5

Lack of medical explained sx do NOT equal a

Answer 5

psychiatric dx

Question 6

illness anxiety disorder

Answer 6

xs worry, not normal health anxiety or adjustment disorder

Key criteria….
1. PREOCCUPATION w/ acquiring an illness

2. NO somatic sx (mild, if any)
3. High level anxiety about HEALTH
4. xs health related behaviors/maladaptive avoidance
5. MORE THAN 6 mo.

Question 7

SSD time requirement for dx

Answer 7

more than 6 mo.

Question 8

Conversion Disorder

Answer 8

requires clear evidence of incompatibility w/ neurological disease

Key criteria…
1. One or more sx altered voluntary/sensory function

2. Evidence of incompatibility between sx and recognized neuro/med conditions
3. not better explained by medical/substance/mental health disorder
4. sx cause SIGNIFICANT DISTRESS/IMPAIRMENT in social, occupation etc.

Question 9

Acute vs. Persistent Conversion Disorder

Answer 9

acute conversion disorder: <6 mo.

persistent: >6 mo.

Question 10

Psychological factors affecting other medical conditions

Answer 10

1. a medical sx or condition MUST be present (other than a mental disorder)
2. physiological or behavioral fx adversely affect the medical condition in one ways
3. not better explained by another medical disorder

Question 11

Psychological factors affecting other medical conditions

-examples

Answer 11

long term work stress and HTN

anxiety and asthma

depression and CAD

alcohol use d/o and liver disease

smoking and COPD

obesity and diabetes

Question 12

only somatic sx disorder that responds to meds

Answer 12

body dysmorphic disorder responds to high-dose SSRI’s and CBT

Question 13

Factitious Disorder

Answer 13

• previously Munchausen’s
• imposed on self/others
• falsification of physical/psychological signs, sx
• presents themselves as impaired
• deceptive behavior present in absence of external rewards

Question 14

other specified somatic sx disorder

Answer 14

less than 6 mo. duration

exp. pseudocyesis (false pregnancy)