Somatization Conversion And Factitious Disorder’s Flashcards
Somatization disorder
Prominence of somatic, (bodily) symptoms associated with significant distress and impairment
Commonly encountered in primary care
Somatic symptom disorder
At least one but often multiple physical symptoms
Excessive anxiety about these symptoms, despite reassurance that the concerns are unfounded
These patients often get repeated evaluation from multiple providers, but extensive lab tests and studies that often come up negative
Diagnosis of somatic symptom disorder, depends on…
The extent to which the thoughts feelings and behaviors related to the symptoms are excessive or out of proportion
Treatment for somatic symptom disorder
Regularly scheduled visit with single primary care physician
Patients almost always resist referral to mental health professionals
Key to managing somatic symptom disorder
To balance the need for a prudent medical evaluation with the very real risk of over diagnosis or over treatment
Reassure the patient that, although the test perform have been normal, that does not mean that but they’re experiencing is not happening
Conversion disorder
A patient complains of a neurological symptom(numbness blindness or paralysis) despite the absence of evidence of physical cause
“Conversion” suggests that…
The patients are subconsciously, converting their psych distresses into Neuro symptoms
For conversion disorder to be present, the patient must have what?
At least one or a logical symptom, either sensory or motor, which cannot be explained by neurological condition
What symptoms may have patient with conversion disorder describe?
Blindness
paralysis
Seizures
Mutism
Paresthesias
Conversion disorders are most common in what population?
Women
Prognosis for conversion disorder
Poor
Illness, anxiety disorder
Patient is preoccupied with having or acquiring a serious illness in the absence of any significant or concerning symptoms
Last six months
A 45-year-old woman admits to a lifelong fear of colon cancer; she reports that both her parents, as well as her sisters, died of this disease.
She does not have any worrisome symptoms, such as blood in the stool, weight, loss, or a domino pain, but she still request frequent valuations by her family physician, and often wonders whether or not she should be having another colonoscopy - even though she has been advised with a past normal exam, repeat screening before 5 to 10 years is not medically indicated
Because of her concern about this diagnosis, she will not equal food, and takes great pans to eat fiber, rich diet. She also recently made an appointment with a gastroenterologist, just to get a second opinion.
This woman is likely suffering from what disorder?
Illness, anxiety disorder
Factitious disorder
A patient produces or fakes, physical or mental illness when they’re really not sick, or intentionally makes a minor illness worse
May also create illnesses or injury, and a third party
Patient fakes symptoms and illness by fabricating them
People with factitious disorder’s seem to be seeking what?
Unconscious, emotional gain
Key= absence of material reward (malingering would have material reward)
Infection, hypoglycemia, abdominal pain, seizures, hematuria, or psychological issues are the commonly faked symptoms of what disorder?
Factitious disorder
What is the old name for factitious disorder’s?
Munchhausen syndrome
Munchhausen syndrome by proxy
Refers to the intentional production of signs or symptoms of illness, and someone else who is in your care (think gypsy rose)
Patience with factitious disorder is eventually require ________________
Confrontation
Malingering disorder
Illness falsification to obtain an external benefit
Not a mental illness because they’re doing it for secondary gain
How is factitious disorder, separated from malingering?
Factitious disorders are better explained by a deep-seated need for attention and love, and are willing to undergo expensive and painful diagnostic procedures
A 37-year-old man who shows up at your hospitals, epilepsy support group claims to have disabling seizures; he is a self proclaimed “expert“ on epilepsy, and yet cannot tell you what medication he is taking. When confronted, he collapses on the ground, thrashing wildly, and then rules and moans dramatically. Despite your reservations about this behavior, you call 911. It is later determined that the patient has lost his job and is looking for Social Security disability benefits. What is the diagnosis?
Malingering
A 52-year-old female patient is hospitalized multiple times for repeated episodes of unexplained sepsis. She finally worked as a nurse, but then lost her job after a car, accident left her disabled, depressed, and dependent on “painkillers“ apart from chronic low back pain, she is otherwise healthy and has no risk factors for infection, such as diabetes, HIV, or other immunosuppression. her blood cultures consistently grow out multiple fecal, micro organisms. After being confronted, the patient admits that they have been injecting themselves with fecal material. What is the likely diagnosis?
Factitious disorder
A conversion disorder must require what
A nervous system symptom
Hysteria
Completely replaced by a more precise Termanology today-conversion and somatization
Malingering involves…
Conscious manipulation or fabrication of symptoms for secondary gain
Not mental illness
