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PSYCHOLOGY > Somatic Symptom Disorders > Flashcards

Somatic Symptom Disorders Flashcards

1
Q

what is a Somatic Symptom Disorder?

A

signs and symptoms with no evidence of disease. “physical manifestations of emotional states”

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2
Q

definition of somatization

A

the expression of psychological stress through physical symptoms

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3
Q

what are the types of somatic disorders

A
  1. somatic system disorder
  2. illness anxiety disorder
  3. conversion disorder
  4. psychological factors affecting medical condition
  5. Factitious disorder
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4
Q

what age group of women are more likely to receive a somatic disorder diagnosis?

A

16-25

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5
Q

people with somatic disorders feel what instead of anxiety, depression or irritability?

A
  1. pain
  2. paralysis
  3. unexplained skin rashes
  4. other physical symptoms
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6
Q

symptoms of somatic symptom disorder?

A
  • chest pain
  • fatigue
  • dizziness
  • headache
  • swelling
  • back pain
  • SOB
  • insomnia
  • abdominal pain
  • Numbness
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7
Q

What is illness anxiety disorder?

A
  • misinterpretations of physical sensations as evidence of a serious illness.
  • can be very obsessive
  • they use 48-78% more health care services then other patients with illness.
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8
Q

what is conversion Disorder

A
  • shows as a neurological symptom with no neurological diagnosis
  • deficits in normal voluntary motor or sensory functions
  • channeling of emotional conflicts or stressors into symptoms
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9
Q

what are some signs of conversion disorder

A
  • paralysis
  • blindness
  • movement disorder
  • gait disorder
  • numbness
  • paresthesia (tingling or burning)
  • loss of hearing
  • seizures resembling epilepsy
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10
Q

what childhood experiences can cause conversion disorder?

A
  • abuse (physical or sexual)
  • depression
  • anxiety
  • PTSD
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11
Q

illness anxiety disorder is defense against..

A

guilt, low self esteem

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12
Q

what are secondary gains?

A

benefits from the symptoms alone.

ie. patient can skip work our home duties or get pity

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13
Q

Assessment guidelines of somatic symptom disoder

A
  1. assess for: of symptoms
    - nature
    - onset
    - location
    - characteristics
    - duration
  2. ability to meet basic needs
  3. risks to safety and security
  4. are symptoms under their voluntary control?
  5. what are their secondary gains?
  6. cognitive style and ability to communicate needs and feelings
  7. type and amount of meds they are using
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14
Q

which disorder would say, “i woke up this morning and couldnt feel my arms”?

A

Conversion disorder

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15
Q

which disorders say, “The pain was searing, like a hot sword drawn across my forehead”?

A

illness anxiety disorder and somatic symptom disorder

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16
Q

which illness would describe a headache as a potential brain tumour?

A

Illness anxiety disorder

17
Q

six key recommendations for developing effective relationships with and treatment for patients with somatic symptom disorder

A
  1. continuity of care
  2. avoid unnecessary test and procedures
  3. frequent, brief, regular office visits
  4. always conduct physical exam
  5. avoid harsh comments on it not being “real”
  6. set reasonable goals
18
Q

how to work around patients and secondary gain?

A

teach them to work around their symptom

ie. if pt is blind and eating use the clock to say where it is, or if paralysis on one limb teach them to eat with the other hand.

19
Q

what is factitious disorder?

A

pts intentionally and consciously feign illness. pretend to be ill

20
Q

what does the first sub type of self directed factitious disorder look like?

A

do not “doctor shop” they stay at the same health care provider.
often in emerg and convincing
dont want family or friends to find out

21
Q

what is the name for the second sub type of self directed factitious disorder?

A

Munchhausen’s syndrome

22
Q

what is Munchhausen’s syndrome?

A

when the pt fakes ill and goes from hc provider to another.

23
Q

what is the name of the others-directed factitious disorder?

A

Munchhausen’s syndrome by proxy

24
Q

what is Munchhausen’s syndrome by proxy?

A

when a caregiver deliberately feigns illness in a vulnerable dependent.

25
Q

what is malingering?

A

related to factitious disorders. acting to gain something.. like welfare or disability compensation

26
Q

Which nursing diagnosis should be investigated for patients with somatic symptom disorders?

A

ineffective coping

27
Q

Which disorder is characterized by the patient’s misinterpretation of physical sensations or feelings?

A

Illness anxiety disorder

28
Q

class of medications commonly prescribed for somatic symptom disorders?

A

anixiolytics

29
Q

A 28-year-old woman, who has been experiencing stress from the demands of her three pre-school-age children, suddenly develops paralysis of both lower extremities. Her neurologic examination is negative. The nurse should suspect that the woman is experiencing which somatization disorders?

A

Conversion disorder

30
Q

A client with frequent visits to the Ambulatory Health Department has had frequent negative medical work-ups with various specialists but worries frantically that he is dying from a severe catastrophic medical illness. The staff suspect that the client is experiencing symptoms of..

A

illness anxiety disorder (Hypochondiasis)

31
Q

what is body dysmorphoric disorder

A

belief that one’s own appearance is unusually defective (worthy of hiding or fixing)

32
Q

what is anhedonia

A

the inability to experience pleasure from activities usually found enjoyable, e.g. exercise, hobbies, music, sexual activities or social interactions.

33
Q

A patient is given acetaminophen 300 mg with codeine 30 mg (Tylenol No.3) for pain. Acetaminophen and codeine are given together because

A

One acts on the peripheral and the other on the central nervous system

34
Q

Ms. T’s family confides in the nurse that she has stopped going to work and church because she is worried that her breath is offensive to other people despite negative dental and ENT workups. The family reports that no one else can smell anything, but Ms. T is unconvinced and covers her mouth when others are around and won’t eat with her family at home or in public. The nurse suspects the patient may be experiencing symptoms of a

A

body dysmorphic disorder

35
Q

Interventions for all somatic disorders?

A

CBT

36
Q

Interventions for somatic symptom disorder

A

Consistent primary care provider with regular pt visits and limited tests
Group therapy
CBT

37
Q

Interventions for illness anxiety disorder

A 
CBT
Insight oriented therapy
Group therapy
Psychopharmacological management for co morbid conditions
Stress management
38
Q

Interventions for conversion disorder

A 
Suggest that conversion symptoms will gradually improve 
Behavioural therapy
Insight oriented therapy
Hypnosis
Anti anxiety drugs
39
Q

Factitious disorder interventions

A

Highly treatment resistant **
Confrontation is counterproductive
Emphasis on management over care
Legal interventions may be necessary in case of munchausens by proxy

PSYCHOLOGY (17 decks)

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