Somatoform Disorders

Question 1

Factitious Disorder

Answer 1

Previously Munchausen’s

The goal is to attain the sick role because it helps them cope with the real world - primary gain.

Patients are aware they are feigning symptoms but experience a “compulsion” similar to that of an addiction.

Behaviour changes when they know they are being observed.

Self-inflicted injuries and tampering with lab results.

Tx: Promote adaptive coping and psychotherapy.

Question 2

Malingering Disorder

Answer 2

The goal is to assume symptoms for external incentives such as money, avoiding duty/work, or obtaining drugs - secondary gain.

Discrepancy between subjective claims and objective findings.

Lack of cooperation with evaluation.

Feigning symptoms.

Tx: Gentle confrontation - with evidence

Question 3

Conversion Disorder

Answer 3

Symptoms affecting movement or sensation (extra movements, unusual sensation, or deficits)

Neurological symptoms only

Caused by an abnormal stress response that activates a neurologic response instead of the normal fight or flight response.

Tx: Treat like an anxiety disorder / acute stressor

Question 4

Somatic Symptom Disorder

Answer 4

1+ somatic symptoms that are distressing with disproportionate concern and a high level of anxiety about the symptoms.

Symptom(s) present for more than 6 months.

Differentiate from illness anxiety disorder by the presence of actual symptoms.

Question 5

Illness Anxiety Disorder

Answer 5

Pre-occupation with having or acquiring a serious illness.

Concern is disproportionate with the risk of developing illness.

Present for 6+ months.

Question 6

Body Dysmorphic Disorder

Answer 6

Pre-occupation of an imagined defect in appearance that “needs to be fixed”.

Concern impacts functioning because of excessive preoccupation.

Looks like OCD for a specific body part.