Somatic Symptom Disorders

Question 1

Somatic symptom disorders

Answer 1

Experience of significant physical symptoms for which there is no apparent medical (organic) cause

Question 2

Criteria of somatic symptom disorder

Answer 2

• Experience of 1 or more somatic symptoms causing significant distress or impairment
• Excessive worry or time and energy
• Symptoms may change, but having symptoms is constant
• May include pain or other physical issues (doesn’t have to be pain related)

Question 3

Specific disorders

Answer 3

• Somatic Symptom Disorder
• Illness Anxiety Disorder
• Conversion Disorder
• Factitious Disorder

Question 4

Illness anxiety disorder (hypochondriasis)

Answer 4

• Worries about having a serious illness
• Somatic symptoms need not be present, but if so, mild and lead to worry and care-seeking
• Health related behaviours or avoidance

Question 5

Theories of somatic symptom disorder/illness anxiety disorder

Answer 5

Cognitive factors play a strong role:
- Dysfunctional beliefs about illnesses (e.g. certain kinds of parental neglect -> view in children that they only get attention when sick)
- Pay too much attention to physical changes and catastrophize symptoms
Post-traumatic stress disorder places people at risk for developing one of these disorders

Question 6

Treatment of Somatic Symptom Disorder and Illness

Anxiety Disorder

Answer 6

• Psychodynamic therapies: Provide insight into the connection between emotional and physical symptoms
• Behavioural therapies: Reward healthy behaviors and remove rewards related to symptoms
• Cognitive therapies: Challenge catastrophizing and learn to interpret physical symptoms appropriately (more positive effects than psychodynamic)
• Antidepressants: Do reduce somatic complaints

Question 7

Conversion disorder

Answer 7

• Neurologic issues in a sensory or motor modality without a physical cause
• E.g., Glove anesthesia (a mental disorder involving loss of sensitivity in the hand and wrist)

Question 8

Factitious disorder

Answer 8

• Deliberate faking to gain attention

- Can be imposed on another

Question 9

Freudian theory of conversion disorder

Answer 9

• Psychic energy from repressed emotions is transferred to a part of the body
• Primary gain – physical symptoms allow person to avoid anxiety
• Secondary gain – attention from others, relieved of obligations

Question 10

Behavioral theory of conversion disorder

Answer 10

• Alleviates stress by removing individual from the environment
• La belle indifference (lack of concern towards their “disability”)

Question 11

Neurological theory of conversion disorder

Answer 11

• Sensory motor areas in the brain impaired by anxiety

- Impaired connectivity with areas regulating anxiety