Somatiform Disorders

Question 1

What is a somatiform disorder?

Answer 1

physical symptoms that have no organic cause; not consciously feigning symptoms

Question 2

What are the criteria for a somatization disorder?

Answer 2

multiple vague complaints involving many organ symptoms. Onset before the age of 30. Worried about symptoms.

hx of multiple doctors visits (f >m)

Question 3

How would we treat a somatization disorder?

Answer 3

regular visits, reinforce non-complaining behavior, refuse to see psych

Question 4

What is conversion disorder?

Answer 4

atleast one neurological symptom, not intentionally produced. Patient is CALM (la belle

most likely paralysis or blindness or lump in throat
remits spontaneously

Question 5

What is the treatment for conversion disorder?

Answer 5

non reinforcement of symptoms, insight oriented psychotherapy, most spontaneously recover

can give truth serum

Question 6

What is the criteria for hypochondriasis?

Answer 6

Prolonged, exaggerated concern about health and possible illness. Misinterprets normal bodily function as indicative of disease.

fear is persistent despite appropriate medical eval
men and women equally affected

Question 7

What is the course for hypochondriasis?

Answer 7

episodic, waxes and wanes, exacerbates under stress

Question 8

What is the treatment for hypochondriasis?

Answer 8

regular visits with ONE doctor, SSRI, information, relaxation

Question 9

What is body dysmorphic disorder?

Answer 9

preoccupied with body parts that they perceive as flawed of defective, extremely self conscious, spend significant amount of time trying to correct flaws

90% have comorbid depression

Question 10

What is the treatment for body dysmorphic disorder?

Answer 10

plastic surgery DOES NOT help. SSRIs work in 50% of pts

Question 11

What is a factitious disorder?

Answer 11

intentionally produced medical or psychological symptoms in order to assume the role of he sick patient

PRIMARY GAIN

Question 12

What disorder is a/w factitious disorder?

Answer 12

munchhausen syndrome- predominantly a physical complaint

Question 13

What is the treatment for factitious disorder?

Answer 13

supportive confrontation, avoid unnecessary treatment

Question 14

What are the criteria for somatiform pain disorder?

Answer 14

prolonged severe discomfort w/out adequate medical explanation.
hx of doctor visits
pain at one or more anatomical site
abrupt onset

Question 15

What is the treatment for somatiform pain disorder?

Answer 15

SSRI and psychotherapy

Question 16

What is malingering?

Answer 16

feigning of physical or pych symptoms to achieve personal gain. Multiple vague complaints, generally uncooperative and refuse a good prognosis

SECONDARY GAIN

Question 17

What is the treatment for malingering?

Answer 17

symptoms often resolve once the desired objective is gained

Question 18

What are the criteria for dissociative identity disorder?

Answer 18

presence of two or more identities that recurrently take control of the persons behavior and actions, inability to recall personal info. Earlier onset = worse prognosis

worst prognosis of dissociative disorders

Question 19

What is the gender preference for DID?

Answer 19

90% women

Question 20

What is a common co-morbidity with DID?

Answer 20

PTSD

Question 21

What is the treatment for DID?

Answer 21

hypnosis, ativan, psychotherapy