Somatoform Disorders

Question 0

Diagnostic criteria of Somatization disorder:

Answer 0

-Multiple somatic symptoms over several years
<30, starts in adolescence but established by the age of 25
-4 pain, 2 GI(not pain), 1 sexual(not pain), 1 pseudoneurological
-Either can not be fully explained or symptoms are in excess of what is expected for the GMC or substance or medication
-Not intentionally produced

Question 1

Diagnostic Criteria for Conversion disorder:

Answer 1

• 1 or more deficits affecting voluntary motor or sensory function suggesting neurological or general medical condition
• Psych factors associated w/ deficit b/c initiation/exacerbation preceded by conflict or stressors
• Symptoms are NOT intentionally produced or feigned (as in factitious disorder or malingering
• Symptoms cannot be fully explained by general medical condition, substance effects, or cultural behavior
• Symptoms cause significant distress/impairment in social, occupational, or other areas of functioning
• Not limited to pain/sexual dysfxn; does not occur exclusively during disorder, doesn’t fit other disorder
• Specify symptoms or deficit
  
  • Motor, sensory, seizure/convulsions, or mixed presentation

Question 2

Diagnostic criteria for Pain disorder:

Answer 2

• Pain in one ore more sites causing impairment
• Psych factors have rome in onset, severity, and exacerbation
• Not intentionally produced
• Not accounted for by mood, anxiety, or psychotic disorder,

Question 3

Diagnostic Criteria for Body dysmorphic disorder:

Answer 3

• Possible anxiety disorder
• Personality traits- Obsessional and avoidant
• Preoccupied with imagined defect in apperance

Question 4

Diagnostic Criteria for Hypochondriasis

Answer 4

• Excessive preoccupation or worry about having a serious illness
• 6 or more months & persists despite medical eval & reassurance
• Not delusional
• Not related to appearance
• Not intentionally produced
• Not explained by GAD, OCD, panic disorder, MDD, separation anxiety, or other somatoform disorder

Question 5

Diagnostic Criteria for Undifferentiated somatoform disorder:

Answer 5

• Undifferentiated- 1 or more physical sxs that last 6 months+
• NOS- <6months eg. pseudocyesis
• More commonly diagnosed

Question 6

differences between conversion disorder, factitious disorder, and malingering

Answer 6

• Conversion disorder:
  
  • Mechanism of illness production: unconscious
  • Motivation for illness production: unconscious
• Factitious Disorder:
  
  • Mechanism of illness production: conscious
  • Motivation for illness production: unconscious
• Malingering:
  
  • Mechanism of illness production: conscious
  • Motivation for illness production: conscious

Question 7

diagnostic features of malingering.

Answer 7

• Intentional production of false/grossly exaggerated physical/psychological symptoms
• Motivated by external incentives:
  
  • avoiding work, compensation, avoiding prosecution, etc
• Often male w/ obvious reasons to feign illness
• Suspect when:
  
  • medicolegal context
  • discrepancy w/ objective findings
  • noncompliant
  • antisocial disorder
• Symptoms reported are often vague, subjective and unverifiable

Question 8

diagnostic features of factitious disorder

Answer 8

• Intentional production of symptoms w/ no external incentive
• FDO in self or by proxy (parent induces illness in child)
• Chronic and begin in early adulthood
• Often in people w/ experiences w/ hospitalization or illness
• Mainly women
• Present w/ extensive medical vocab, textbook symptoms, excessive surgeries, demand specific meds