Somatoform and Factitious disorders Flashcards
enduring physical symptoms without an identifiable organic cause, which causes significant distress or impairment in social, occupational or other areas of functioning
Somatoform Disorder
symptoms as an unconscious defense against unacceptable internal conflicts ( self justification for various actions or lack of actions)
primary gain
symptoms that provide unconscious external benefits (increase attention from others, decreases responsibilities , avoidance of law, etc)
secondary gain
onset of somatization disorder
before age 30
somatization disorder: need at least how many pain sx? how many GI? How many sexual or repro? Neuro?
4 pain
at least 2 GI
at least 1 sexual or repro
at least 1 pseudoneuro, not limited to pain
pts who have at least one neuro sx (sensory or motor) that cannot be explained by a medical disorder
onset is usually preceded or exacerbated by a psychological stressor, although pt may not connect the two
Conversion Disorder
common sx in conversion disorder
shifting paralysis, blindess, mutism, paresthesias, seizures, globus hystericus ( sensation of lump in throat)
The only somatoform disorder that does NOT have a higher frequency in women?
Hypochondriasis
Criteria for Pain Disorder
patient’s main complaint is pain at one or more anatomic sites, of sufficient severity to warrant clinical attention
the pain causes significant distress or impairment in the patients life
psychological factors play an important role in the pain
not intentionally produced
Tx for pain disorder
SSRIs
what can exacerbate the sx of pain disorder
major depression
patients intentionally produce signs of physical or mental disorders, they produce the sx to assume the sick role (primary gain), lack of secondary gain distinguishes this from malingering, there is no external incentives (money, etc) as in malingering
factitious disorder
Difference between malingering and factitious disorder
Malingering, the motivation is external (achieve personal gain: avoiding police, receving room and board, obtaining narcotics, receiving monetary compensation)
Factious disorder the motivation is internal
Malingering is more common in which gender
Men!!