Somatoform and Factitious Disorders Flashcards
If someone is consciously feigning symptoms in order to get something like money, what’s the diagnosis?
malingering
What are the diagnostic criteria for somatization disorder?
onset before age 30
at least four pain symptoms
at least 2 GI symptoms
at least one sexual/reproductive symptom
at least one pseudoneurological symptom not limited to pain
cannot be explained by something else (or if there is a general medical condition, the physical complaints are in excess of what would be expected)
symptoms must not be intentionally produced (because that would be malingering)
What percentage of those with somatization disorder will have a comorbid medical condition?
50%
What should be the relationship between the primary care provider and a patient with somatization disorder?
they should have regularly scheduled visits to limit, but not eliminate medical workups
WHat are the diagnostic criteria for conversion disorder?
at least one neurological symptom
psychological factors associated with initiation or exacerbation of symptoms
not intentionally feigned or produced
not explained by anything else
causes significant distress/impairment in social functioning
not limited to pain or sexual dysfunction and not better accounted for by a different mental disorder
what are some common types of conversion disorder symptoms?
shifting paralysis, blindness, mutism, paresthesias, non-epileptic seizures, globus hystericus (sensation of lump in one’s throat)
What is the preferred treatment for a conversion disorder?
insight-oriented psychotherapy
hypnosis
relaxation therapy
most patients spontaneously recover
What are the diagnostic criteria for hypochondriasis?
preoccupation with fear of having or contracting a serious disease, based on misinterpreting bodily symptoms
persists despite medical evaluation and reassurance
not of delusional intensity and not restricted to a circumscribed concern about appearance
significant impairment in functioning
persists for at least 6 months
not better accounted for by another mental disorder
What are some good prognostic factors for hypochondriasis?
higher SES
treatment-responsive anxiety or depression
absence of comorbid medical conditions and personality disorders
What are the diagnostic criteria for body dysmorphic disorder?
patients w/ body dysmorphic disorder are preoccupied with body parts that they perceive as flawed or defective, having strong beliefs that they are unattractive or repulsive
though their physical imperfections are either minimal or completely imagine, patients view them as severe and grotesque
very self-conscious about appearance
spend significant amount of time trying to correct perceived flaws with makeup, derm procedures or plastic surgery
When is the average age of onset for body dysmorphic disorder?
15-20
What is the treatment for body dysmorphic disorder?
surgical or dermatological procedures are routinely unsuccessful in pleasing the patient
SSRIs may reduce symptoms in 50%
What are the diagnostic criteria for pain disorder?
patients main complain is pain at 1+ anatomic sites of sufficient severity to warrant clinical attention
pain causes significant distress or impairment in life
psychological factors play an important role in the pain
not intentionally produced
not better accounted for by a mental disorder or meet criteria for dyspareunia
Which gender is more likely to have pain disorder?
women
What is the therapy for pain disorder?
SSRIs, biofeedback, hypnosis, and psychotherapy
analgesics not helpful
