Somatoform Disorders Flashcards
Explain primary gain and secondary gain in understanding somatoform disorders
Primary gain involves using the defense mechanism of somatization to unconsciously express an unacceptable emotion as a physical symptom to avoid dealing with the emotion
Secondary gain means that the symptom, once established, serves a useful purpose, such as getting attn from others or avoiding responsibility
When do somatoform disorders arise and do they get better?
start in early adulthood and have chronic symptoms that worsen during times of stress and that improve when life conditions are favorable
Most of these somatoform d/os occur more commonly in women, except which one that occurs equally among men and women?
hypochondriasis
List the 4 DSM V somatoform disorders and the 3 that were considered somatoform disorders in DSM IV
1) somatization disorder (somatic symptom disorder)
2) conversion disorder
3) hypochondriasis (in DSM V, not considered)
4) body dysmorphic disorder (BDD)
5) pain disorder (in DSM V, not considered)
6) Factitious disorder
7) Malingering (in DSM V, not considered)
At least how many symptoms does a patient with somatization disorder (somatic symptom disorder) have? Can these symptoms be explained by medical testing? When do symptoms start? Unconsious or conscious?
- at least 4 pain issues (2 GI; 1 sexual; 1 neurological) that cannot be explained by labs, tests, exams, etc.
- onset before 30
- unconscious, no secondary gain, pts unaware of behaviors and symptom generation
What is conversion disorder? WHat is it preceded by? Conscious or unconscious? Lifelong?
Sudden and dramatic loss of one or more voluntary motor and/or sensory functions suggesting a neurologic etiology. Often preceded by psychological stress or conflict. Patients may seem uncaring/unconcerned (“la belle indifference”). Usually self-limited with remission in < 1 month. It’s unconscious, no secondary gain
Hypochondriasis (Illness anxiety disorder) is no longer considered a somatoform d/o based on the DSM V. What is it? How long must symptoms persist? conscious or unconscious?
fear or idea of having a serious medical illness based on misinterpretation of bodily symptoms. This persist after negative findings and reassurance from medical staff, leading to doctor shopping. Symptoms must persist >/- 6 months. Unconscious, no secondary gain, pt unaware of behaviors and symptom generation
What is body dysmorphic disorder? Is it conscious or unconscious?
Body dysmorphic disorder is a preoccupation with an imagined problem or insignificant abnormality in appearance -usu involving the face or head. It CANNOT be accounted for by an eating disorder. Unconscious, no secondary gain, pt unaware of behaviors and symptom generation
Pain disorder is no longer considered a somatoform disorder under the DSM V. What is it?
Protracted pain that is severe enough to cause the patient to seek medical attn. It cannot be explained by physical causes. Onset is around 30s, 40s. Unconscious, no secondary gain, pt unaware of behaviors an symptoms.
What is factitious disorder? Conscious or unconscious?
Conscious feigning or production of physical or mental illness in order to receive attn from medical personnel. There is possible secondary gain to feel proud, able to figure things out that doctors cannot.
What is factitious disorder by proxy?
most commonly, a parent feigns or induces illness in a child to gain attn for him or herself. It is considered child abuse.
Malingering is no longer considered a somatoform disorder in the DSM V. What is malingering?
conscious stimulation or exaggeration of physical or mental illness to achieve some sort of secondary gain. Symptoms improve as the secondary gain is obtained.
