somatisation

Question 1

examples of chronic somatisers

Answer 1

-non-cardiac chest pain
-chronic fatigue syndrome
-IBS
-fibromyalgia
-functional neurological symptoms disorder
-somatic symptom disorder

Question 2

common somatised symptoms

Answer 2

-chest/back pain
-fatigue
-dizziness
-headache
-dysphonia
-numbness/tingling
-weakness

Question 3

aetiology of somatised illness predisposing factors

Answer 3

1. predisposing factors
   -childhood illness coupled with lack of parental care
   -physical illness in family
   -childhood abuse
   -genetics

Question 4

precipitating factors for somatised illness

Answer 4

-stressful events
-psychiatric illness
-minor injury

Question 5

perpetuating factors

Answer 5

-inconsistent/ambiguous medical advice
-family/spouse collusion
-threat of withdrawal of social benefits
-involvement in litigation
-fear of disease

Question 6

consequences of chronic somatisation

Answer 6

Over-investigation / iatrogenic illness, e.g. surgery.
Repeated hospitalisations.
Misuse of prescribed drugs, e.g. opioids.
Inability to work / invalidism / financial difficulties.
Family / relationship breakdown.
Deterioration in doctor / patient relationship, e.g. repeated requests for “second opinions”, “more tests”.

Question 7

what is somatic symptom disorder

Answer 7

multiple distressing somatic symptoms which result in significant disruption of daily life and functioning

Question 8

what is functional neurological symptom disorder

Answer 8

one or more neurological symptoms unexplained by any specific disease process affecting the nervous system

Question 9

what are the symptoms of FND

Answer 9

-weakness or paralysis
-tremor
-gait abnormalities
-abnormal limb posturing
-altered skin sensation
-visual field abnormalities
-imapired hearing
-double vision
-non-epileptic attacks

Question 10

treatment

Answer 10

-screen for depressive/anxiety disorder
-consider antidepressants
-psychological treatment
-physiotherapy