Somatisation Flashcards
Define somatisation.
Repeated presentation for medical symptoms requesting investigation and diagnosis with no biological cause found, and continous resistance to discuss psychological basis.
Explain the aetiology/risk factors for somatisation.
Low threshold for consulting doctors.
Often acquired attitudes in childhood when illness behavior is associated with positive reward.
Some genetic component.
High proportion also have personality disorder, anxiety or depression.
More common in women than men.
Usually <30y/o
Summarise the epidemiology of somatisation.
Lifetime prevalence 0.1%.
What are the signs and symptoms of somatisation?
Multiple, recurrent and frequently changing physical symptoms (i.e. abdominal pain, fatigue, dizziness, pins and needles)
Symptoms may affect any system but usually GI, derm, sexual, menstrual.
No physical explanation found in symptoms. Symptoms often present for >2y and there is persistant refusal to accept advice even from >1 doctors. Social or occupation functioning often impaired as result of behavior.
What investigations should be performed for somatisation?
Full physical examination and investigation for illness.
What is the management for somatisation?
Seen by same doctor each time if possible. Treat associated anxiety or depression. Be clear about the negative investigations and findings. Do not conduct further investigations. Acknowledge phsychological distress and offer help.
Elicit childhood illness hx, encourage coping strategies and letting go of sick role. Involve family who may be reinforcing the behavior.
What are complications associated with somatisation? What is the prognosis of somatisation?
New symptoms may come on in times of stress.
Chronic and fluctuating, often resistant to treatment.
