Somatisation

Question 1

ICD 10 definition fo smatisation

Answer 1

A form of Medically unexplained sysmpotoms (physical sx with no organic cause_

-Multiple, recccurent and frequently changing sx of >2y
Associated with complicated Hx woth medical care (esp investigations gone wrong)
Sx may be reffered to any part of body
chronic and fluctuationg -but disrupts normal acitvity
F»M

Question 2

What are the different somatisation subtypes

Answer 2

Undifferentiated somatoform disorder - miltiple varying persistent complains <2y (less than full def of over 2y)
Hyponchrial disorder–often cancer related-SINGLE ISSUE–
presistent preocupation with the idea of having serious/progressive disorder -normal sensation are abnormal/distressing
co-morbid anxiety/depression
pt maintain belief despite being told otherwised

somatoform autonomic dysfunction - sx presented as if due to a physical disorder are of ANS origin/control -
objective -palps, sweating, tremor, flushing, sweating
subjective -fleeting aches and pain, burning sensation, bloating

PErsistant somatoform pain disorder-
persistnet, severe and distressing pain that cant be explained
evidence of emotional conflict or psychosocial issues

Question 3

Sx of somatisation disorders ((and co-morbidities)

Answer 3

sx-
Multiple, reuccrent and frequently changing physical sx
Hx of bad interactions with meidcal professionals -with no outcome
Social and occupational outcomes

co-morbid background
anxiety, depression, alcoholh and drugs, Hisitronic PD, dissocial PD

Question 4

Ix of soamtisation

Answer 4

Full hx and MSE (with physical exam)
exclude organic causes for sx and for beliefs (Stroke, phsyhcosis, etc)
exclude co-morbid conditions

Question 5

Mx of somatisation

Answer 5

most based as coucelling –
continuiy of care is important (same dr everytime

1st line -explain and reassure
broaden clinical agenda -not just physical but physical and psych causes
-be clear about negative findings and link to pyshc causes (acknoledge distress)
explain that there will no be further Ix and why stopping
emotional support- encourage coping strategies an letting go of innapropriate sick role
involve fam

2nd line- CBT

treat comorbid conditions