somatiform

Question 1

Somatoform Disorder
Things you should know
___ symptoms with no discernible cause
Symptoms are sometimes similar to those of other illnesses, usually begin appearing during ___, and patients are diagnosed before the age of ___ years
Is it the result of conscious malingering or factitious disorders?
Symptoms are real?

Answer 1

Physical symptoms with no discernible cause
Symptoms are sometimes similar to those of other illnesses, usually begin appearing during adolescence, and patients are diagnosed before the age of 30 years
Not the result of conscious malingering or factitious disorders. Symptoms are real.

Question 2

Preoccupied with concern they have a serious disease and believes that minor complaints are signs of very serious medical problems

• duration
• coexist with what
• exacerbated with what
• tx

Answer 2

Hypochondriasis
sx last 6 months or more and impair functioning
anxiety and depression
after a major stressor
psychotherapy and SSRI

Question 3

Obsessed with, or may exaggerate, a physical flaw.

• gender/age
• tx
• other comorbid d/o

Answer 3

Body dysmorphic disorder
females; onset 15-30 y/o
Serotonin modulating drugs(fluoxetine, clomipramine); SSRI with higher dosages; 10-12 weeks
Major depressive episode followed by anxiety d/p

Question 4

Neurological symptoms that can’t be traced back to a medical cause. – Patient may be indifferent to the symptoms

• most common symptoms
• concern
• prevalence
• age
• gender

Answer 4

Conversion disorder

• shifting paralysis, blindness, mutism
• lack of concern/indifference for symptoms
• 20-35% incidence in general medical practices
• adolescence and young adulthood
• common in female

Question 5

People with this disorder typically experience pain that started with a psychological stress or trauma

Answer 5

Pain disorder

Question 6

A patient has seen several plastic surgeons and no less than three dermatologists in the past 6 months. Which somatoform disorder might she be suffering from?

Answer 6

Body dysmorphic disorder.

Question 7

somatoform disorder 
gender
age
50% have what
socioeconomic group
course of illness

Answer 7

often males
onset before 30 y.o, commonly adolescence
50% have comorbid mental d/o
low socioeconomic group

Question 8

Conversion disorder

• what typically occurs before onset or will worsen it
• tx

Answer 8

a catastrophic event
psychotherapy first line tx
hypnosis, short term anxiolytics(lorazepam, relaxation therapy

Question 9

factious disorder

• primary motivation
• age
• prognosis
• tx

Answer 9

• primary motivation: assume sick role
• age: early adulthood
• prognosis: poor
• tx: approach in a non threatening manner; maybe SSRI for impulsive tendencies

Question 10

pt expresses vague, poorly defined complaints and claim that these symptoms cause great distress and impaired functioning; self inflicted injuries; hx reveals multiple undiagnosed illnesses or previous injuries, and even tampering of labs results

Answer 10

malingering

Question 11

pain disorder

• sx intentionally produced?
• onset insidous or abrupt
• what is an important factor in the pathogenesis
• peak onset
• gender
• tx

Answer 11

• sx intentionally produced? no
• onset abrupt
• what is an important factor in the pathogenesis: psychological factor(stress or loss of a loved one)
• peak onset: 30-50
• gender: woman 2:1
• tx: SSRI and TCA; psychotherapy, behavior therapy, pain control programs

Question 12

hoover sign

Answer 12

extension of affected leg when asked to raise the unaffected contralateral leg
conversion disorder

Question 13

difference between factious d/o and malingering

Answer 13

malingering is for secondary personal gain($$ or housing); and factious is just to assume sick role

Question 14

munchasen by proxy what disorder

Answer 14

factious