Somatic Syndrome/ MUPS

Question 1

MUPS stands for?

Answer 1

Medically unexplained Physical Symptoms

Question 2

Whats the distinguishing factor between DSM V and DSM IV

Answer 2

DSM V now emphasizes diagnosis made on the basis of positive symptoms and signs (distressing somatic symptoms plus abnormal thoughts, feelings, and behaviors in response to these symptoms) rather than the absence of a medical explanation for somatic symptoms.

It is important to note that some other mental disorders may initially manifest with primarily somatic symptoms (e.g., major depressive disorder, panic disorder)

Question 3

The five Somatic Symptom and Related Disorders are?

Answer 3

1. Somatic symptom disorder
2. Illness anxiety disorder
3. Conversion disorder
4. Psychological factors affecting other medical conditions
5. Factitious disorder

Note there can be significant overlap between these!

Question 4

Factors contributing to somatic-related disorders

Answer 4

• Low threshold to pain
• Previous experiences and trauma
• Societal norms/setting which favours phsyical over psychological
• Learn: attention gained from illness

Question 5

Diagnostic Criteria of a Somatic Symptom Disorder?

Answer 5

1. one or more somatic symptoms that are distressing or result in significant disruption of daily life.
2. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns….
   
   • Disproportionate and persistent thoughts about the seriousness of one’s symptoms.
   • Persistently high level of anxiety about health or symptoms.
   • Excessive time and energy devoted to these symptoms or health concerns.
3. State of being symptomatic is persistent (typically more than 6 months), can be differing symptoms

Question 6

In Conversion Disorder the essential feature is?

Answer 6

neurological symptoms that are found, after appropriate neurological assessment, to be incompatible with neurological pathophysiology

1. 1 or more symptom that alters voluntary motor or sensory function
2. Clinical findings provide evidence of incompatibility between the symptom and recognised neur
3. ological or medical conditions.
4. The symptom or deficit is not better explained by another medical or mental disorder.
5. The symptom or deficit causes clinically significant distress or impairment … or warrants medical evaluation

Question 7

Illness Anxiety Disorder

Answer 7

If the individual has extensive worries about health but no or minimal somatic symptoms, it may be more appropriate to consider …..

• Preoccupation with having a serious illness or acquiring one
• Somatic symptoms not present or mild
• High anxiety about health
• Excessive health related behaviours- checks body, or avoids appts/hospitals

This is also classified as an anxiety disorder as somatic symptoms are minima

Question 8

Once/while you’ve made a diagnosis of Somatic Symptom Disorder, what things do you need to specifiy

Answer 8

• Pain
• Persistence
• Current Severity

Question 9

Common somatic symptoms in Children?

Answer 9

• Frequent headaches
• Recurrent abdominal pain
• Limb pain
• Fatigue daily

Pseudo-neurological symptoms rare

It is more common in children to have a single recurring symptom, and they worry much less about the “illness”

Question 10

What are some differential diagnoses to consider over Somatic symptom Disorder?

Answer 10

Question 11

Negative outcomes of kids with somatic disorder?

Answer 11

• Do worse psychosocially
• Miss more school
• do worse academically
• Have higher level of internalising sx
• Increased ambulatory healthcare
• Percieved as less healthy by parents