Somatic Symptoms & Related Flashcards
a patient has increased health anxiety, frequent office visits, unnecessary labs or imaging tests. what could they be experiencing?
somatic symptoms & factitious disorders
diagnosis that is made on the basis of positive symptoms and signs (distressing feeling about the symptom), rather than the absence of a medical explanation for somatic symptom
somatic symptom disorder
how long should a patient be in the state of being persistently symptomatic to be diagnosed with somatic symptom disorder?
more than 6 months
what diagnostic can be used for somatic symptoms disorder?
patient health questionnaire
what must be excluded to diagnose a patient with somatic symptom disorder? (2)
factious disorder
malingering
what is the general management for somatic symptom disorder?
review criteria with patient explaining the disorder as a medical condition
how often should visits be scheduled for somatic symptom disorder?
4-8 weeks
what is the treatment/medication used for somatic symptoms disorder?
SSRI, SNRI, TCA
CBT
abnormal nervous system functioning in the absence of structural pathology; symptoms are genuine and cause distress
conversion disorder
a patient presents with weakness, abnormal movements, nonepileptic seizures, and blindness - without structural pathology. what are they likely experiencing?
conversion disorder
what is the first line treatment for conversion disorder?
patient education about the syndrome
what is the second line treatment for conversion disorder? (2)
CBT
physical therapy
what are nonepileptic seizures?
trance-like state with rhythmic movements
what is the 3rd line treatment for conversion disorder? (3)
antidepressants
hypnosis
family/group therapy
preoccupation for 3-8 hrs/day with nonexistent or slight defects in physical appearance; patients believe they look abnormal, unattractive, ugly, or deformed, when they look normal
body dysmorphic disorder
what kind of procedures do patients with body dysmorphic disorder seek?
dermatologic
surgical procedures
a patient presents with preoccupations, compulsions to fix/hide appearance, poor insight and delusions, social avoidance, emotional distress, and somatic symptoms. what are they likely experiencing?
body dysmorphic disorder
what is the treatment for body dysmorphic disorder? (3)
SSRI
CBT
education - patient and family
what is important to remember in patients with body dysmorphic disorder?
relapses can occur
what are the 3 most common comorbidities associated with body dysmorphic disorder?
depression
personality disorders
substance use disorders
creating symptoms or signs in yourself or in somebody else for the purpose of self-worthiness; actual medical abnormalities are created
factitious disorder
for a patient with possible factitious disorder imposed on another, what should the medical provider do?
review all medical records
obtain comprehensive H&P
confirm hx with other clinicians
identify whether symptoms
depend upon perpetrator’s presence
what is the management for factitious disorder imposed on another? (3)
contact child/adult protective services
stop medications
try to correct iatrogenic damage
