Somatisation disorder Flashcards
Who does SD affect?
-Usually begins <30s and more common in women
What causes SD?
Defined by ICD-10 as:
-Multiple, recurrent and frequently changing physical symptoms usually present for several years before referral
-‘Unexplained somatic complaints’ described those presenting with physical symptoms and frequent medical visits despite negative investigations
What risk factors are there for SD?
-Higher percentages in those with IBS and chronic pain
-PTSD
-Antisocial personality disorder
-Hx of sexual / physical abuse
-Often associated with unmet needs for closeness with others
How does SD present?
-Symptoms can vary and affect any of the systems
-Combinations of symptoms for which no organic cause can be found
-Exacerbated by stress
-Often a diagnosis of exclusion
-Symptoms are vague
-Chronic course
-May be a presence of psychiatric disorder / Hx of extensive diagnostic testing
How would you investigate a patient with SD?
-Diagnosis of exclusion
-Extensive Hx and examination
What treatment would you consider for someone with SD?
-PC must be involved
-Interventions directed at reducing specific sources of stress
-Physical exercise (improves self esteem, time away from stressors)
-Stress management interventions eg yoga classes
-CBT approaches
What is the difference between somatisation and conversion disorders?
-CD = voluntary motor / sensory function deficits that suggest neuro / medical causes but investigations cannot find an organic cause
-SD = 1+ somatic symptoms that are distressing / cause significant disruption to daily life
What are the DSM-5 diagnostic criteria for somatic symptom and related disorders?
-Disproportionate and persistent thoughts about the seriousness of one’s symptoms
-Persistently high levels of anxiety about health / symptoms
-Excessive time / energy devoted to symptoms or health concerns
