Somatoform and Fictious disorders- Carlson Flashcards
What is the criteria for a somatic symptoms disorder?
Presence of physical symptoms:
-that suggest a medical condition but explanatory physical findings are absent and it is not caused by a substance or another med condition AND it causes signif clinical distress or impairment in social/occupational areas
(blank) is characterized by difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal.
alexithymia
What psychological factors are usually present with somatic symptoms disorder?
stress
dependency
limited insight
not psychologically-minded
What medical disorders do you need to rule out before diagnosing someone with somatic symptom disorder?
- MS
- systemic lupus erythematosus
- acute intermittent porphyria
- myasthenia gravis
- ALS
What psychiatric disorders do you need to rule out before diagnosing someone with somatic symptoms disorder?
- delusional disorder
- affective disorder
- anxiety disorder
How do physicians react to somatoform patients?
- scared they are missing something
- disgusted
- name-calling
- anger (giving in, indignant refusal to be manipulated, professional aloofness)
Where did the DSM place pain disorder?
Body dysmorphic disorder?
Factitious disorder?
under somatic symptom disorder
OCD
now part of somatic symptom and related disorders
What do we call hypochdriasis now?
illness anxiety disorder
What is the criteria of somatic symptom disorder?
- one or more somatic symptoms that are distressing or disrupt life
- excessive thoughts, feelings, or behaviors
- persistence of symptoms for 6 months
How will a person with somatic symptom disorder react to their symptoms?
- with high levels of anxiety about symptoms
- w/ excessive time and energy spent about them
- disproportionate thoughts about the seriousness of sx
What are 2 other names for somatic symptom disorder?
briquettes syndrome
histeria
What is the Lifetime prevalence of somatic symptom disorder?
0.1%-.4%
Who gets somatic symptom disorder more commonly, men or women?
Does it run in families?
women
- **Female to male ratio 10:1-20:1
- found in 10-20% first degree female relatives
- male relatives have an increased risk of somatization disorder, antisocial personality disorder, substance abuse disorder
What disorders and life events are often associated with somatic symptom disorder?
depression (2.8 X more likely)
GAD (2.5 X more likely)
History of physical and sexual abuse higher
Higher rates of childhood illness or fmaily member with chronic illness
When do you typically see somatic symptom disorder?
What type of doctor most commonly sees it first?
What does the mental status exam look like?
What will the symptoms fluctuate with?
What is the course like?
- teen onset
- gynecologist or neurologist
- dramatic, vague, complicated, seductive, manipulative and emotional
- stress
- chronic
What are some complications associated with somatic symptom disorder?
unnecessary surgical procedure
drug dependence
suicide attempts
relationship problems
How do you manage a SSD patient?
- establish good relationship
- see regularly
- be cautious with prescriptions and surgeries
- treat co-morbid psychiatric illnesses
- colleagial support
what is a conversion disorder?
What is the onset associated with?
Is it intentionally induced?
Symptoms or deficits affecting voluntary motor or sensory system (blindness, paralysis, dysphonia, seizures) THAT CANNOT be explaind by medical condition, substnace or behavior/experience
stress
no
What designates acute conversion disorder?
What designates chronic conversion disorder?
less than 6 months
greater than 6 months
What are the subtypes of conversion disorder?
- weakness or paralysis
- abnormal movements
- swallowing sx
- speech sx
- sensory
- seizure/convulsion
- mixed