Somatoform disorders Flashcards
Somatisation disorder ICD 10 criteria Briquets syndrome
> 2 years duration
Multiple, recurrent and frequently changing symptoms in absence of physiological explanation
-GI
-sexual/reproductive
-urinary
-neurological
Persistent refusal by patient to accept reassurance
Functional impairment
15-50% of all patients
Often dependent on sedatives and analgesia
Hypochodriacal disorder
Persistent belief in the presence of at least one serious physical illness
Repeated presentations despite investigations and reassurance
Misinterpret normal body sensations
Seek a definite diagnosis
Factitious disorder / Munchausen’s
Patient feigns symptoms for no obvious reason
May inflict harm on self or others
Internal motivation of adapting the sick role
1-2% of patients
Often a manifestation of psychological distress
Malingering
Conscious manufacturing of symptoms for a secondary gain
Management of somatoform disorders biological
Treat co morbid psych and physical conditions
Some evidence for antidepressants
Management of somatoform disorders psychological
Psychoeducation
Psychotherapy
Supportive, empathetic relationship
Schedule regular appointments that are fixed
Management of somatoform disorders social
Encourage them to talk about emotional problems
Only 1 or 2 Dr’s
Involve family and carers
Somatisation definition
Psychological distress is expressed through physical symptoms and subsequent medical help seeking