Somatic Symptom & Related Disorders Lecture Powerpoint

Question 1

__% of patients in primary care demonstrate some degree of somatization

Answer 1

25%

Question 2

Somatoform disorders definition

Answer 2

Physical symptoms suggesting a medical condition yet the symptoms are not fully explained by the medical condition, substance abuse, or other mental disorder that is severe enough to cause distress or impaired social, occupational, or other functioning despite not being intentionally produced

Question 3

Somatic symptom disorders etiology (3)

Answer 3

• idiopathic
• interpretation of symptoms as social communication
• Genetic component

Question 4

Somatic symptom disorder diagnostic criteria

Answer 4

• Age <30
• 4 pain symptoms from 4 different sites including 2 GI (other than pain), 1 sexual, and 1 pseudoneurological NONE of which are explained by physical or lab findings

Question 5

Somatic symptom disorder clinical presentation (4)

Answer 5

• Nausea
• Menstrual disorders
• suicide threats
• manipulative behavior

Question 6

Factitious syndrome definition

Answer 6

Patients adopting physical symptoms for unconscious internal gain (patient desires to take on role of being sick)

Question 7

Malingering syndrome definition

Answer 7

Purposeful feigning of physical symptoms for external gain (financial or legal benefit)

Question 8

Somatic symptom disorders prognosis

Answer 8

• Chronic and debilitating
• Episodic/cyclic symptoms
• Worsened by increased stress

Question 9

Somatic symptom disorder treatment (2)

Answer 9

• Psychotherapy/mindfulness therapy

- Single health care provider following them over time with regular appointments

Question 10

Somatic symptom disorder mental status exam shortcomings (2)

Answer 10

• Insight is limited in that nonmedical causes of symptoms are not considered
• judgement is impaired

Question 11

Conversion disorder/functional neurological symptom disorder definition

Answer 11

Characterized by presence of one or more neurologic symptoms (blindness, paralysis) that cannot be explained by known medical condition and psychological factors are known to be associated with the initiation of the disorder

Question 12

2 theorized etiologies of conversion disorder/functional neurological symptom disorder

Answer 12

• Psychoanalytic (repression of unconscious intrapsychic conflict and conversion of anxiety into a physical symptom)
• Biologic (hypometabolism in dominant hemisphere of brain and hyper in nondominant)

Question 13

conversion disorder/functional neurological symptom disorder diagnostic criteria

Answer 13

• Symptoms affect voluntary motor or sensory function
• Inability to explain symptoms on basis of any neurologic disease
• Excludes symptoms of pain and sexual dysfunction

Question 14

conversion disorder/functional neurological symptom disorder clinical presentation (4)

Answer 14

• Paralysis or blindness
• Inconsistent anesthesia and paresthesia
• ataxia (wild staggering gait)
• reflexes intact, no fasciculations, no atrophy

Question 15

conversion disorder/functional neurological symptom disorder treatment (2)

Answer 15

• Usually spontaneously resolves, longer it persists worse prognosis
• Resolution facilitated by insight behavior therapy

Question 16

Illness Anxiety Disorder (hypochondriasis) definition

Answer 16

Preoccupation with the fear of contracting, or the belief of having, a serious disease that results from unrealistic or inaccurate interpretations of physical symptoms

Question 17

Illness Anxiety Disorder (hypochondriasis) etiology

Answer 17

• Social learning theory
• variant of anxiety
• lower tolerance for physical discomfort

Question 18

Illness Anxiety Disorder (hypochondriasis) diagnostic criteria

Answer 18

• Must hold preoccupation for at least 6 months

- does not have delusion but significant enough to cause emotional distress or impair ability to function

Question 19

Illness Anxiety Disorder (hypochondriasis) clinical presentation (2)

Answer 19

• Conviction of having yet undetected disease despite neg lab results and assurance
• accompanied by anxiety or depression

Question 20

Illness Anxiety Disorder (hypochondriasis) treatment (3)

Answer 20

• Improves over time (episodic)
• Group therapy
• Single provider

Question 21

Pain disorder definition

Answer 21

Symptoms of pain associated with emotional distress and funcitonal impairment where pain is predominant focus of clinical attention not fully accounted for by medical conditions

Question 22

Pain disorder etiology

Answer 22

-Psychodynamic, interpersonal, or biologic factors

Question 23

Pain disorder diagnostic criteria

Answer 23

-Acute or chronic (6 month period) of pain causing emotional distress or functional impairment

Question 24

Pain disorder treatment (2)

Answer 24

• Behavioral therapy

- NO long term analgesics