Somatoform Disorders, Factitious Disorders, Malingering

Question 1

What is the term for:

individuals who present with medical symptoms that are not consciously created and occur due to unresolved unconscious conflict

Answer 1

Somatoform disorder

Question 2

What is the term for:

patients hwo consciously feign symptoms to be in the sick role for unconscious reasons

Answer 2

factitious disorder

Question 3

What is the term for:

individuals who consciously create symptoms of mental or physicla illness for the soncsious purpose of monetary gain or to avoid an unwanted consequence

Answer 3

malingering

Question 4

What is the term for:

one or more somatic complaints that are disruptive to the person’s life, typically persist(s) more than 6 months in duration, and may have pain as its predominant complaint

Answer 4

somatic symptom disorder

Question 5

What is the term for:

an individual who has a preoccupation with the possibility of having or developing an illness. It has persisted for > 6 mo. The individual regulary assesses self or the possibility of illness. If they do have somatic symptoms they are mild at most. This generates a lot of anxiety for the individual.

Answer 5

Illness Anxiety Disorder

Question 6

What is the term for:

an individual who has an alteration or decrement in voluntary motor function or neurological function that does not have a true underlying medical or neurological cause

Answer 6

Converstion Disorder

acute < 6 mo.

persistent > 6 mo.

Question 7

What the term for:

the indivdual creates signs & symptoms of an underlying physical or mental illness or injury (or imposes this on to another person). This behavrior occurs even if no demostratable gain is evident

Answer 7

Factitious disorder [Munchausen’s & Munchausen’s by proxy]

creates symptoms consciously d/t unconscious conflict

Question 8

It is easier to define malingering than to what?

Answer 8

identify it

Question 9

How can you differentiate malingering from factitious disorder?

Answer 9

factitious disorder enjoy the attention from being ill rather than some other benefit they could gain from being ill

factitious disorder is a mental illness; malingering is not (may still require ‘clinical attention’)

Question 10

What does a V code from the DSM-5 indicate?

Answer 10

a condition that may require “clinical attention”

Question 11

Malingering is a special concern in what situations?

Answer 11

jails & prisons

• receive medications
• placed on disability
• alternate housing
• mental illness diagnosis may keep them from being punished when breaking the rules
• may try to gain admission to avoid the legal system / gain food or shelter

Question 12

Making a diagnosis of malingering comes with what additional risks?

Answer 12

can be sued fro slander or malpractice - even if it was made in good faith

Question 13

Fill out the provided table:

Answer 13

Question 14

What are the somatoform disorders?

Answer 14

somatic symptom disorder

conversion disorder

illness anxiety disorder

Question 15

What are the types of factitious disorder?

Answer 15

• primarily psychological type
  
  • pseudologica fantastica
  • impostership
• primarily physical type
  
  • von munchausen’s
  • con munchausen’s by proxy
• combined

Question 16

Fill out the provided diagram with the following disorders:

Malingering

Factitious Disorder

Somatoform isorder

Answer 16

Question 17

What is repression?

Physical mainfestation?

These symptoms are seen in what conditions

Answer 17

keep a lid on the unconscious (requires a lot of energy)

disruption of sleep schedule, disturbance of appetite, disruptionfo memory & concentration, lack of energy (fatigue) & loss of libido

depression & anxiety disorders

Question 18

What disorders are examples of repression?

Answer 18

somatization disorder & conversion disorder

Question 19

What are the substance most commonly abused (in order of preference)

Answer 19

1. Alcohol
2. Ciagrettes (& other tobacco/nicotine products)
3. Prescription medications & illicit methamphetamine
4. Marijuana

Question 20

What characteristics move a patient from abuse to dependence?

Answer 20

dependence: tolerance and/or withdrawal symptoms

Question 21

What are the 4 experiences that are classified as abuse?

Answer 21

• use of the substance impairs the person’s ability to perform important daily life activities at work, home, or school
• use of the substance occus in places & situations that are inadvisable & put the individual or others at risk for their safety (ie driving)
• use of the substance results in legal consequences
• use of the substance persists even though it is causing impairment in the person’s life either in daily life functioning or in relationships at home, school or work

Question 22

What is CAGE?

Answer 22

2/4 + = alcohol abuse

• C - have you tried to Cut down on your use of alcohol
• A - have you ever been Annoyed by people commenting about your alcohol use
• G - have you ever felt Guilty or worried about your use of alcohol
• E - have you ever had an Eye-opener drink in the morning

Question 23

What two laboratory values are indicative of alcoholism?

Answer 23

• gamma-glutamyltranspeptidase (GGT) - elevated levels in 75% alcohol abusers
• mean corpuscular volume - elevated in 95% alcohol abusers

Question 24

What is the triad of Wernike encephalopathy?

cause?

treatment?

Answer 24

• ataxia
• confusion
• horizontal nystagmus

d/t thiamine (vit B1) deficiency

100mg intramuscular thiamine

Question 25

What is the triad of Wernike encephalopathy? cause? treatment?

Answer 25

Wernicke encephalopathy + confabulation severe thiamine (nutritional) deficiency IM thiamine, but 2/3 never recover