Somatoform Disorders (9) Flashcards
Name the 7 somatoform disorders:
1- somatization disorders
2- Conversion disorder
3- Hypochondriasis
4- Body Dysmorphic disorder
5- Pain disorder
6- Factitious disorder
7- Malingering
What is the difference between primary and secondary gains?
Primary is for internal/ psychic motivations
Secondary is for external motivations (getting help, housing, drugs)
Which somatoform disorders have a conscious production of symptoms?
Facticious disorder and malingering
What conditions are the “great pretenders”?
Depression and anxiety
Within whom are somatoform disorders usually seen in and when in life do they start?
Higher incidence in women and usually start in early adulthood (and worsen with stress)
What is the etiology of somatoform disorders?
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
Describe the symptoms seen in somatization disorder?
4 or more pain issues (2 GI, 1 sexual, 1 neuro) that cant be adequately explained by medical causes
Can somatization disorder be “cured”?
Symptoms tend to be chronic and complete remission is rare
What is conversion disorder?
Sudden and dramatic loss of one or more volunatary motor and or sensory functions suggesting a neurologic etiology
What usually occurs before conversion disorder?
psychological stress or conflict–> presenting symptom tends to have a symbolic relationship with a stressor and served to decrease anxiety associated with it
What is an “odd” finding with conversion disorder?
patients seems uncaring/ unconcerned about their remarkable symptoms
Who is conversion disorder most common in?
Individuals that are psychiatrically unsophisticated and people with depression
What is hypochondriasis?
Fear or idea of having a serious medical illness based on misinterpretation of bodily symptoms
Symptoms must persist for more than 6 months
What is hypochondriasis called now and what is it thought to be?
Illness Anxiety Disorder
It is part of the generalized anxiety disorder spectrum
What is body dysmorphic disorder?
preoccupation with an imagined problem or insignificant abnormality in appearance (usually involves the head or face)
What is pain disorder?
Protracted pain that is severe enough to cause the patient to seek medical attention.
Cannot be explained by physical causes
Criteria for acute and chronic pain disorder?
Acute: 6months
What must be on the differential diagnosis for unconscious somatoform disorders?
1- Unidentified organic illness
2- Depression/ anxiety
30 factitious disorder and malingering
How are unconscious somatoform disorders managed? (5)
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
What is factitious disorder?
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
What is factitious disorder also known as?
Munchausen syndrome
What are some commonly feigned or produced signs and symptoms in factitious disorder?
Abd pain, fever, hematuria, seizures, skin lesions, tachycardia, hypoglycemia, fever, DVT
What is malingering?
NOT a psychiatric illness
Conscious simulation or exaggeration of physical ir mental illness to achieve some sort of secondary gain
When do “symptoms” seen with malingering subside?
As soon as the secondary gain is obtained
