Somatoform Disorders Flashcards
T/F: Somatic symptom disorders are NOT characterized by physical symptoms for which no underlying medical workup can identify a cause
False
They are
What may you expect to see a patient with somatic symptom disorders to continually do?
Seek Medical Help
Have multiple visits
Seek invasive procedures
What percentage of primary care patients will exhibit medically unexplained symptoms?
30%
For the diagnosis of somatic symptom disorder, how long must symptoms be present?
6 months
T/F: Somatic symptoms disorder can affect multiple organ systems?
True
What is unique about the symptoms patient with somatic symptoms disorders present with?
They often can not be measured……
GI Upset
Malaise
Blurry Vision
Do patients with somatic symptom disorder typically live normal lives?
Not always, they often become preoccupied with there symptoms to the point in interferes with their ADLs
How prevalent is somatic symptoms disorder?
Is it more common in men or women?
5-7%
More common in women
T/F: Somatic symptom disorder patients are unlikely to have co-morbid conditions like depression or anxiety
False
They are likely to have those co-morbid conditions
In patients with illness anxiety disorder, would you expect a negative work up to reassure the patient?
No, they are often not reassured by a negative work up
T/F: A patient with illness anxiety disorder will likely down play their diagnosis
False
They often feel their diagnosis is worse than it actually is
In a patient with illness anxiety disorder which is worse…..
The Sx or The Anxiety
The anxiety is often far worse for the patient than the actual symptoms
To be diagnosed with illness anxiety disorder symptoms most be present for ___ months
6 months
T/F: Patients with illness anxiety disorder are hypervigilant about their health and monitor their bodies frequently
True
In ________ disorder patients often have one or more symptoms of voluntary motor or sensory loss that is not consist with any known diagnosis
There is often a psychological component to the disorder however is not needed for diagnosis criteria
Conversion Disorder (Functional Neurological Symptom Disorder)
If a patient with conversion disorder presents with complaints of pain, how does this change their diagnosis?
They now get diagnosed with somatic symptom disorder
In ________ (acute/chronic) conversion disorder symptoms last less than 6 months
Acute
In ________ (acute/chronic) conversion disorder symptoms last more than 6 months
Chronic
What percentage of patients admitted to a neurology service have conversion disorder?
20-25%
T/F: in conversion disorder symptoms are typically permenant
False
Symptoms are typically transient
What treatment method has the best outcome for patients with conversion disorder?
Clearing of any stressors that may be precipitating the symptoms
The following are all complaints of patients with ________ disorder
Paralysis Abnormal movements (twitching) Aphonia Blindness Deafness Pseudoseizures Loss of sensation/anesthesia over part of body
Conversion Disorder
Although medication is not needed to treat conversion disorder…..
What medication class has been shown to have improvement in conversion disorder (previously hypochondrosis)?
SSRIs
________ disorder is described as a patient intentional producing or feigning physical or psychological symptoms without clear external evidence as to why.
Some of these patients will go as far as make hospitalization a way of life.
Factitious Disorder
T/F: Patients with factious disorder often present with symptoms that are NOT textbook
False
They often present with textbook symptoms
What are two good ‘precautions’ to take when interviewing and examining patients with factitious disorder?
Obtain PMHx/Records
Speak with previous providers
What consult should be obtained if you suspect factitious disorder?
Psychology
__________ is described as purposely producing symptoms or illnesses for specific gains such as missing work, compensation, obtaining medication, etc….
Malingering
T/F: Malingering is considered a mental illness
False
It is not
Dissociative disorders are classified by disturbances or alterations in what three things?
Identity (Dissociative identity disorder - multiple personality)
Memory (Dissociative amnesia)
Consciousness (Depersonalization disorder)
T/F: Daydreaming is considered a normal dissociation
True
Is dissociative identity disorder often the result of a medical condition or substance?
No
How many personality states may a person with dissociative identity disorder exhibit?
Two or more
Is dissociative identity disorder more common in men or women?
Women
T/F: in severe cases of dissociative identity disorder patients often have a history of physical or sexual abuse
True
In dissociative identity disorder……
What often triggers transitions between personalities?
Stress
What percent of patients with dissociative identity disorder have underlying psychological disorders?
70%
What is the ‘mainstay’ of dissociative identity disorder management?
Psychotherapy
Dissociative _______ is described as the inability to recall important autobiographical information including their own name
Dissociative Amnesia
What percent of dissociative amnesia cases last less then one week?
About 79%
What are TWO common triggers of dissociative amnesia?
Stress
Trauma
T/F: Patients with dissociative amnesia will often exhibit sudden unexpected travel
True
In a patient with dissociative amnesia, what things need to be ruled out?
Brain Tumors
Epilepsy
Dementia
(Can NOT be due to a substance abuse)
How is dissociative amnesia managed?
It tends to resolve spontaneously however psychiatric admission may be needed
Once the overwhelming condition resolves the symptoms symptoms also resolve
Therapy should be considered once memory returns.
____________ disorder is characterized by feeling detached from one’s self or surroundings feeling like they are a “outside observer” of their life.
Depersonalization/Derealization Disorder
__________ (Depersonalization/Derealization) Disorder is characterized by a strong sense that the patient is ‘cut off’ from their own thoughts, emotions, and identity
Depersonalization Disorder
__________ (Depersonalization/Derealization) Disorder is characterized by a sense of detachment, unreality, and altered relation to the outside world”
Derealization Disorder
T/F: Depersonalization/Derealization disorder is less common in people who have experienced trauma or life-threatening conditions
False
It is more common in people who have experienced those
What may exacerbate episodes of Depersonalization/Derealization Disorder?
Stress
What CNS disturbances may accompany a patient with Depersonalization/Derealization Disorder?
Seizure
Tumors
Stroke
What medication class can be used to treat anxiety in patients with Depersonalization/Derealization Disorder?
Anxiolytics
Although there is no standard treatment in Depersonalization/Derealization Disorder……
What medication class has been shown to improve symptoms?
SSRIs
