Somatoform Disorders (9)

Question 1

Name the 7 somatoform disorders:

Answer 1

1- somatization disorders

2- Conversion disorder

3- Hypochondriasis

4- Body Dysmorphic disorder

5- Pain disorder

6- Factitious disorder

7- Malingering

Question 2

What is the difference between primary and secondary gains?

Answer 2

Primary is for internal/ psychic motivations

Secondary is for external motivations (getting help, housing, drugs)

Question 3

Which somatoform disorders have a conscious production of symptoms?

Answer 3

Facticious disorder and malingering

Question 4

What conditions are the “great pretenders”?

Answer 4

Depression and anxiety

Question 5

Within whom are somatoform disorders usually seen in and when in life do they start?

Answer 5

Higher incidence in women and usually start in early adulthood (and worsen with stress)

Question 6

What is the etiology of somatoform disorders?

Answer 6

1- Runs in families

2- Increased incidence with a family history of alcoholism, OCD/ Mood disorder, and antisocial personality

3- Serotonin related gene pathways may be involved

Question 7

Describe the symptoms seen in somatization disorder?

Answer 7

4 or more pain issues (2 GI, 1 sexual, 1 neuro) that cant be adequately explained by medical causes

Question 8

Can somatization disorder be “cured”?

Answer 8

Symptoms tend to be chronic and complete remission is rare

Question 9

What is conversion disorder?

Answer 9

Sudden and dramatic loss of one or more volunatary motor and or sensory functions suggesting a neurologic etiology

Question 10

What usually occurs before conversion disorder?

Answer 10

psychological stress or conflict–> presenting symptom tends to have a symbolic relationship with a stressor and served to decrease anxiety associated with it

Question 11

What is an “odd” finding with conversion disorder?

Answer 11

patients seems uncaring/ unconcerned about their remarkable symptoms

Question 12

Who is conversion disorder most common in?

Answer 12

Individuals that are psychiatrically unsophisticated and people with depression

Question 13

What is hypochondriasis?

Answer 13

Fear or idea of having a serious medical illness based on misinterpretation of bodily symptoms

Symptoms must persist for more than 6 months

Question 14

What is hypochondriasis called now and what is it thought to be?

Answer 14

Illness Anxiety Disorder

It is part of the generalized anxiety disorder spectrum

Question 15

What is body dysmorphic disorder?

Answer 15

preoccupation with an imagined problem or insignificant abnormality in appearance (usually involves the head or face)

Question 16

What is pain disorder?

Answer 16

Protracted pain that is severe enough to cause the patient to seek medical attention.

Cannot be explained by physical causes

Question 17

Criteria for acute and chronic pain disorder?

Answer 17

Acute: 6months

Question 18

What must be on the differential diagnosis for unconscious somatoform disorders?

Answer 18

1- Unidentified organic illness

2- Depression/ anxiety

30 factitious disorder and malingering

Question 19

How are unconscious somatoform disorders managed? (5)

Answer 19

1- establish a strong doctor-patient relationship (regular short appointments, constant reassurance)

2- identify/ help decrease social stressors

3- Psychopharmacology (SSRIs)

4- Drug assisted interview under hypnosis

5- Psychotherapy

Question 20

What is factitious disorder?

Answer 20

Conscious feigning or production of physical or mental illness in order to receive attention from medical personelle

To assume the “sick” role, a primary gain to feel safe and cared for, possible secondary gain to feel proud, an expert, smarter than doctors

Question 21

What is factitious disorder also known as?

Answer 21

Munchausen syndrome

Question 22

What are some commonly feigned or produced signs and symptoms in factitious disorder?

Answer 22

Abd pain, fever, hematuria, seizures, skin lesions, tachycardia, hypoglycemia, fever, DVT

Question 23

What is malingering?

Answer 23

NOT a psychiatric illness

Conscious simulation or exaggeration of physical ir mental illness to achieve some sort of secondary gain

Question 24

When do “symptoms” seen with malingering subside?

Answer 24

As soon as the secondary gain is obtained