Somatoform and Factitious Disorders

Question 1

Somatoform Disorders

Answer 1

Present with enduring physical symptoms without an identifiable organic cause which cause significant distress or impairment in social occupational or other area of functioning.
THESE PEOPLE TRULY BELIEVE THERE IS SOMETHING WRONG WITH THEM AND ARE NOT DOING IT TO GET PRIMARY/SECONDARY GAINS. (Unlike malingerers)

Ex: Somatization Disorder , Conversion Disorder, Hypochondriasis, Pain Disorder, Body Dismorphic Disorder,

Question 2

Primary Gain

Answer 2

Symptoms as an unconscious defense against unacceptable internal conflicts.

Question 3

Secondary Gain

Answer 3

Symptoms that provide unconscious external benefits (Attention from others, decreased responsibilities, avoidance of the law.)

Question 4

Somatization Disorder

Answer 4

Multiple non-specific problems involving many organ systems. See many doctors –> extensive work-ups.

Onset before 30
At least 4 pain symptoms
At least two GI Symptoms
At least one sexual or reproductive symptoms
At least one Pseudoneurologic symptom
Physical complaints are in excess of what can be acceptable.

Question 5

Conversion Disorder

Answer 5

Have at least one neurological symptom that cannot be explained by a medical disorder (blindness, paralysis, parasthesia)
Onset is usually preceded by a physiologic stressor.
Patient is surprisingly calm and indifferent

Question 6

Hypochondriasis

Answer 6

Preoccupation of having of contracting serious disease based on misinterpretation of bodily symptoms

Persists despite medical evaluation and reassurance

Persists for at least 6 months

Tx: the usual psychosocial crap + SSRI if needed

Question 7

Body Dysmorphic Disorder

Answer 7

Preoccupied with body parts that they perceive as flawed or defective having strong belief that they are unattractive or repulsive.
They spend significant time trying to correct their perceived flaws ( plastic surgery etc)

Mainly women.

Tx: SSRI’s are good in 50% of cases

Question 8

Pain Disorder

Answer 8

Prolonged severe discomfort without adequate medical explanation
The pain often co-exists with a medical condition but it is not directly caused by it or not fully accounted for by it
Pain must cause significant distress
NOT INTENTIONALLY PRODUCED

Tx: SSRI, biofeedback, hypnosis, and psychotherapy.

Question 9

Factitious Disorder

Answer 9

Intentionally produce medical or psychological symptoms in order to assume the role of a sick patient
Primary gain is the feature of this disorder
Lack of secondary gain distinguishes this from malingering
No external incentives

Avoid early confrontations

Question 10

Malingerings

Answer 10

Feigning of physical or psychological symptoms in order to achieve personal gain. (Secondary Gain)

Multiple vague complaints that do no conform to a known medical condition
Long medical hx with many hospital stays.
Often uncooperative.

More common in men