Somatoform Disorders - Carlson Flashcards
T/F: overworkup of somatoform disorders is common
true
what dz’s must you rule out when thinking about somatoform disorders?
Multiple sclerosis Systemic lupus erythematosus Acute intermittent porphyria Myasthenia gravis A. L. S.
what psych issues must you rule out when working with somatoform disorders?
Delusional disorders
Affective disorders
Anxiety disorders
what is the age of onset for Dx of somatic symptom disorder?
before thirty
which gender is more likely to have a Dx of somatic symptome disorder?
females
what are the areas of findings needed to Dx somatic symptom disorders?
4 pain
2 gastrointestinal
1 sexual
1 pseudoneurological
What are the DSM5 criteria for the length of time spent on somatic symptom disorder?
6 months; excessive time and energy spent, disproportionate thoughts regarding symtpoms
What are the other names for somatic symptom disorder?
Briquette’s Syndrome
Hysteria
Somatization disorder
males with a female relative with hysteria have what psych risk factors?
increased risk of somatization disorder, antisocial personality disorder, substance abuse disorders
What two disorders are more than 2x more likely in hysteria?
depression
GAD
What specific past Hx increases the likelihood of hysteria?
past physical and sexual abuse
childhood illness or family member with chronic illness
what is the MSE like in hysteria?
presentation dramatic, vague, complicated, seductive, manipulative and emotional
Symptoms fluctuate with stress
What are the complications of somatic symptom disorder?
Unnecessary surgical procedures
Drug dependence
Suicide attempts
Relationship problems
what Tx should you be careful with when treating somatic symtpom disorder?
invasive procedures and addictive meds
what is conversion disorder?
Symptoms or deficits affecting voluntary motor or sensory system
Blindness, paralysis, dysphonia, seizures
what is conversion disorder brought on by?
stress
glove anasthesia is a form of…
conversion disorder
conversion disorders onset in which gender and age group?
10-35 in females
prevalence decreases with sociocultural dev and knowledge
conversion disorder may evolve into…
somatic sx disorder in females
conversion disorder is assc’d with what personality disorder in males?
antisocial personality disorder
T/F: a brief duration with recurrence in common in conversion disroder
true
What types of conversion disorder have better prognosis?
paralysis, aphonia, and blindness
worse with tremor and seizure
how do you manage conversion disorder?
Supportive Psychotherapy Determine stressor(s) Help patient problem solve Positive expectations R/O treatable medical conditions
what are the criteria for illness anxiety disorder?
preoccupation with fears of having a serious disease; not delusional; preoccupation persists after workup and reassurance
does illness anxiety affect only females?
both sexes equally
is illness anxiety relapsing?
yes, and chronic
what is the effect of SES on illness anxiety?
higher SES=better prognosis
What is the clinical picture like in illness anxiety?
Fears having a serious illness related to a single body sensation
History of doctor shopping
Brings problem lists
Doubts physician competence
how do you treat illness anxiety?
develop trusting relationship R/O actual illness do brief physical at every meeting establish stress-illness connection consider SSRI supportive psychotherapy
Describe symptom scheduling for illness anxiety?
track primary symptom four times daily at spcecific times
track anxiety and pain
attempt to determine causal relationship between the the two
do it the first time in office
What is factitious disorder?
conscious awareness of what they are doing; actively playing the sick role
Can you have physical symptoms in factitious disorder?
yes
What are the facets that makes factitious disorder an actual disorder?
Maladaptive (can be life threatening)
Motivation unclear to patients
Often underlying personality disorder
May respond to treatment intervention
what is munchausen by proxy?
medical child abuse in which the parent fakes the illness of the kid
what is the difference between malingering and factitious disorder?
malingering has a clear external incentive like drugs or avoiding jail time
do men or women malinger more?
men
Is this factitious or malingering? borderline personality pursue painful tests varied symptoms chronic
factitious
