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Behavioral Health > Somatic Symptoms & Related Disorders > Flashcards

Somatic Symptoms & Related Disorders Flashcards

1
Q

What is the etiology of Somatization?

A

unclear

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2
Q

T/F Somatic disorder is a benign disorder

A

FALSE

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3
Q

What two things does somatic disorder lead to?

A

disability and iatrogenic harm

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4
Q

What is the diagnosis of somatic symptom disorder?

A

basis of positive symptoms and signs RATHER THAN the absence of a medical explanation for somatic symptom

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5
Q

How long does a somatic symptom need to be present

A

6 mo

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6
Q

What is the screening tool for Somatic Symptom?

A

Patient Health Questionnaire (15 item)

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7
Q

What is disorder is a diagnosis of exclusion?

A

Somatic Symptom disorder

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8
Q

What things must be excluded in somatic symptom?

A

lack of physical or lab findings and factious disorder and malingering

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9
Q

What is the goal of treatment for somatic symptom?

A

is management not cure

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10
Q

When should appts be done for somatic symptom?

A

regular outpatient visits (4-8wks) NOT contingent upon SX

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11
Q

What is the treatment for somatic disorder?

A

SSRI, SNRI, TCAs

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12
Q

What is the dosing for meds for somatic disorder?

A

start lowest possible dose and increase slowly

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13
Q

What therapy works best for somatic disorder?

A

Cognitive Behavior therapy

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14
Q

What is conversion disorder?

A

abnormal nervous system functioning in the absence of structural pathology

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15
Q

What are symptoms seen in conversion disorder?

A

weakness, abnormal movements, non-epileptic seizures

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16
Q

What is the difference between conversion and malingering disorder?

A

symptoms are genuine and cause distress and/or psychosocial impairment

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17
Q

What are the ABCD of conversion disorder?

A

A. 1 or more symp of altered voluntary motor or sensory function
B. findings provide evidence of incompatibility between symptom and recognized medical conditions
C. symptom not better explained by other disorders
D. causes distress in social, work etc.

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18
Q

What is the 1st line txt for conversion disorder?

A

pt education about the syndrome

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19
Q

What may be all that necessary for recovery in minority of pts?

A

explanation of the diagnosis

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20
Q

What is the 2nd line txt for conversion disorder?

A

Cognitive Behavioral Therapy and PT

21
Q

What is the 3rd line txt for conversion disorder?

A

Antidepressants, Hypnosis, Family therapy, group therapy

22
Q

What is body dysmorphic disorder?

A

preoccupation w/ non-existent or slight defects in physical appearance, that the pt believe they look abnormal

23
Q

Appearance in mirrors, exercising, starving self, staying home

A

body dysmorphic disorder

24
Q

Causes distress, impaired functioning, and often associated w/ suicidal ideation and behaviors

A

Body dysmorphic disorder

25
Q

When does body dysmorphic usually start?

A

around 17 yo

26
Q

What do most pts w/ body dysmorphic seek for care?

A

dermatologic and surgical procedures

27
Q

T/F Effective treatment is available for body dysmorphic?

A

TRUE

28
Q

What are two symptoms of body dysmorphic disorder?

A

preoccupations and compulsions

29
Q

What percentage of ppl report no change in appearance after cosmetic treatment?

A

91%

30
Q

What is the most common comorbidity found with body dysmorphic?

A

depression

31
Q

What percentage of pts have a history of SI and SA in body dysmorphic?

A

80% and 25%

32
Q

What are 3 risk factors for Body dysmorphic disorder?

A

age on onset <17y
severe symp
comorbid substance use or PTSD

33
Q

What is the med txt of body dysmorphic disorder?

A

SSRI antidepressants

34
Q

What is the treatment of body dysmorphic disorder

A

Cognitive behavioral therapy

Patient and Family Education

35
Q

T/F With successful txt, pt will often have relapses?

A

TRUE

36
Q

What is malingering?

A

illness falsification to obtain external benefits

37
Q

How is malingering described?

A

Not a psychiatric illness and no longer in DSM 5, but added a v-code (descriptor)

38
Q

What 4 things should malingering be suspected in?

A

medicolegal context of presentation
marked discrepancy between the person’s claimed stress or disability and findings
Lack of cooperation during the dx and complying w/ prescribed txt
Presence in the pt of antisocial personality disorder

39
Q

What is the test for malingering?

A

NO SINGLE TEST

40
Q

How should malingering be managed?

A

referral to specialists as needed to r/o disease

41
Q

What is factitious Disorder?

A

a factitious disorder imposed on self or others

42
Q

What is the goal of those with factitious disorder?

A

NONE, achieving the patient role or sympathy towards the perpetrator

43
Q

What are some symptoms that a patient might induce on themselves?

A

self-mutilation, fever, hemorrhage, hypoglycemia, seizures

44
Q

How are symptoms usually presented in factitious disorder?

A

exaggerated and dramatic fashion

45
Q

What is factitious disorder imposed on another?

A

someone creates illness for another person based on psychological benefit of the first person, such as sympathy or a relationship w/ clinicians

46
Q

What is Medical Child Abuse

A

requires the provider to recognize the caregiver is exaggerating, fabricating, or inducing illness in a child

47
Q

What should a medical provider do in medical child abuse?

A

review all of the child’s medical records

48
Q

What should a medical provider do in factitious disorder?

A

obtain a comprehensive history and physical exam
confirm the history with other clinicians
Identify whether symptoms depend upon perpetrator’s presence

49
Q

What is the treatment for factitious disorder?

A 
contact CPS
cancel scheduled but unnecessary surgeries
Stop meds
Correct iatrogenic damage
Take out vascular access

Behavioral Health (14 decks)

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