Somatic Symptom Disorder and Related Conditions Flashcards
Define ILLNESS BEHAVIOUR.
Illness behaviour is the way in which a person monitors their body, defines and interprets their symptoms, takes medication, utilises help etc.
Examples of illness behaviour include:
✔️ choosing to seek medical attention / help when unwell
✔️ self medicating instead of seeking professional help
✔️ ignoring symptoms and foregoing medical advice
Define ABNORMAL ILLNESS BEHAVIOUR.
Abnormal illness behaviour is a maladaptive way of experiencing, evaluating and acting in response to health and illness that is disproportionate to the pathology.
Define the SICK ROLE.
The “sick role” is a culturally acceptable set of guidelines and expectations that govern the rights and responsibilities of people when they are physically and mentally unwell.
Components of the sick role include a person:
✔️ does not have to perform normal duties / roles (e.g. work, study)
✔️ should seek appropriate medical attention and advice
✔️ must try and get well
✔️ is not accountable for his / her illness
The tradition sick role fits well with acute illness, but not with the model of chronic disease.
Define PRIMARY GAIN.
Primary gain is a situation in which an individual falsifies their symptoms due to intrinsic factors / pressures.
Often, this is to alleviate psychological stress.
Results in FACTITIOUS DISORDER.
Define SECONDARY GAIN.
Secondary gain is a situation in which an individual falsified their symptoms due to external pressures / factors.
Often, this is to evade commitments to work, obtain financial gains or avoid military work etc.
Results in MALINGERING.
DSM-V Criteria for SOMATIC SYMPTOM DISORDER.
A. One or more somatic symptoms that are distressing for one’s life.
B. Excessive thoughts, feelings and behaviours related to somatic symptoms, manifested by at least ONE of the following:
✔️ disproportionate and persistent thoughts about severity of symptoms
✔️ persistently high level of anxiety about symptoms
✔️ excessive time and energy devoted to symptoms
C. Although only one symptom may be present at once, the total duration of the symptoms is > 6 months.
Essentially, somatic symptom disorder is a condition in which physical symptoms manifest as a consequence of psychiatric condition; causes significant distress for the individual and impacts their day to day functioning.
Outline key management strategies for SOMATIC SYMPTOM DISORDER.
✔️ frequent, short visits
✔️ limit the number of individuals involved in patient’s care
✔️ early referral to psychology services
✔️ minimise the medications involved
✔️ minimise psychotropic medications
Define ILLNESS ANXIETY DISORDER.
A condition characterised by significant fear / preoccupation of developing a medical illness OR misinterpretation of one or more bodily signs / symptoms as a sign of that illness.
The fear is not alleviated by negative medical results / medical reassurance.
Define CONVERSION DISORDER.
The presence of one or more motor or sensory abnormalities (e.g. double vision, local paralysis, seizures or convulsions) that mimic a neurological condition.
Previously known as “Functional Neurological Symptom Disorder…” however, no longer requires psychological event as precipitant.
Define MEDICALLY UNEXPLAINED SYMPTOMS.
MUS are symptoms that persistent despite lack of evidence for underlying organic medical cause; not necessarily due to psychological cause (although correlation is high).
The RACGP classifies MUS as either:
- elusive illness –> diagnosis is “just around the corner…”
- contensted illness –> every consultation becomes a battleground
- chaotic illness –> problems go down to “bottomless depths…”
Outline key components / considerations for the management of MUS.
✔️ symptom list –> create a symptom list, prioritising what is most important to the patient
✔️ safety netting –> investigate all organic causes to make sure nothing is missed
✔️ optimise the therapeutic relationship
✔️ appropriate lifestyle adivse
✔️ present signifiant symptoms to MDT
