somatoform

Question 1

Prevalence of
Somatization DO
somati sx DO estimate
conversion DO
illness anxiety DO
facticious DO

Answer 1

1%
5%
1/100,000 (1-20% in neuropsych ptn)
1%
1%

Question 2

Female: male ratio in 
Somatization DO
conversion DO
illness anxiety DO
facticious DO

Answer 2

10:1
2-10:1
1:1
? more in females

Question 3

somatic sx DO course

Answer 3

early twenties
very rare to spontaneously remit
high morbdity and mortality

Question 4

somatic sx DO RF

Answer 4

-ve affectivity
low education
low SES
recent stress

Question 5

somatic sx DO poor prognosis

Answer 5

older
female
low ed, ses
childhoodadversity
stress
comorbidity psych or medical
2ry gain

Question 6

somatic sx DO therapies

Answer 6

CBT, DBT, PMR, explore meaning of sx

al this after reassurance, education, alliance

Question 7

somatic sx meds

Answer 7

SSRIS do not help somatic sx

use for CB anxiety or whatever

Question 8

conversion DO:
which side?
CB with what PD in men?
what PD cluster in general?

Answer 8

left side
ASPD
cluster C

Question 9

conversion DO CB (psych)

Answer 9

50% have 
MDD
diisociative DO (up to 80%)
anxiety DO
Axis 2 mainly cluster C

Question 10

medical CB in conversion DO

Answer 10

30% have a neuro Dx
80% have epileptiform activity
75% structural neuro abnormalitues

Question 11

prognosis in conversion DO

Answer 11

sudden onset
resolves in 6 months with no treatment
much faster with tx
most remit, but most will relapse

Question 12

conversion DO tx

Answer 12

reassurance, alliance, rehab, then later sx exploration

CBT, IPT,PMR

Question 13

illness anxiety CB with what PD cluster?
with what axis 1 dx?
onset?

Answer 13

C (like conversion DO)
anxiety
older adults (later than somatic sx DO in early twenties)

Question 14

illness anxiety tx?

Answer 14

CBT (4 RCTs)

SSRIs (no data, but seems like they are as good for illness anxiety as other anxiety DO)

Question 15

factitious DO CB with what PD cluster?

what axis 1?

Answer 15

B
NPD
ASPD
BPD

mood DO

Question 16

factitious DO Mx?

Answer 16

review documents
collaborate with team
physician leads, psychiatrist helps
constructive confrontation with offer of FU and support
document
engage in tx to chalenge illness and learn new coping

Question 17

course of factitious DO?

Answer 17

onset mid 30s
chronic
we think

Question 18

facticious DO imposed on another
perpetrator?
child mortality?
method for adults?
method for child?

Answer 18

99% of time: mother
9%
poisoning
suffocation

Question 19

body dysmorphic DO

Answer 19

in OCD chapter
75% seek Tx to fix deformity
bad outcome<10% satisfied
1-3:1 ratio female: male
Tx: CBT, SSRI (high dose)