somatoform D

Question 1

types of somatoform D

Answer 1

somatization D, conversion D, hypochondriasis, pain D, body dysmorphic D. all expect hypochondriasis is more common in women

Question 2

primary gain

Answer 2

expression of unacceptable feelings as physical sx to avoid facing them

Question 3

somatization D dsm

Answer 3

at least 2GI, 1 sexual/repro, 1 euro, and 4 pain sx. onset bf 30. can’t be explained by med condition or substance use.

Question 4

SOMAtization

Answer 4

so many physical complains. often vague. numerous doctor visits. no cure. multi visit to primary care

Question 5

conversion D dsm

Answer 5

at least 1 euro sx. psychological factors associated with invitation or exacerbation of sx. s not intentionally produced. can’t be explained by medical or substance. cause sig distress or impairment in social or occupational func. not accounted for by somatization D or mental D. not limited to pain or sx sx

Question 6

common sx of conversion d

Answer 6

shifting paralysis, blindness, mutism, paresthesias, seizure, globes hysterics (lump in throat)convert paych prob to neuro prob then spontaneously convert back to normal.

Question 7

cnversion D epi, dd, course, tx

Answer 7

common. any onset. comorbid schizo, mdd, ad. dd medical cause. sx resolve in 1mo. 25% future epic in stress. sometimes reslve after hypnosis or sodium amobarbital interview if psychological trigger uncovered. tx- insight oreiented psychotherapy, hypnosis, relaxation therapy if needed.

Question 8

hypochondriasis

Answer 8

fear serious med condition based on misinterpretation of normal body sx. fear persist despite appropriate med eval. at least 6mo. epic- 20-30s. 80% have MDD or AD. DD med, somatization D. no cure

Question 9

body dysmorphic D tx

Answer 9

surgical/ derm procedure usually unsuccessful. SSRI decr sx in 50% since 90% have MDD

Question 10

pain D dsm

Answer 10

main complaint is pain at one or more anatomic sites. pain cause sig distress in pt’s life, pain related to psych factor. pain not due to med D.

Question 11

pain D tx

Answer 11

analgesics not helpful and cause dependence. use SSRI, transient N stimulation, biofeedback, hypnosis, psychotherapy

Question 12

fictitious D

Answer 12

intentionally produce signs of physical or mental D to assume role of pt (primary gain). no external incentive. either prelim psychiatric complaint(hallu, depression) or physical complaint( fever by heating up thermometer, abound pain, seizure, skin lesion hematuria).

Question 13

munchhausen syndrome

Answer 13

factitious d with prelim physical complaints. often demand specific med.

Question 14

munchhausen syndrome by proxy

Answer 14

intentionally producing sx in someone else under one’s care to assume sick role by proxy

Question 15

factitious syndrome epi course, tx

Answer 15

> 5% hospitalized pt. higher IQ, poor sense of ID, poor sexual adjustment. often hx of abuse or neglect. hospital = good enviro. no tx.