Somatoform / eating disorders Flashcards
What are somatization disorders
psychiatric disorders characterized by the presence of physical complaints
What is another name for somatic symptom disorder
Hypochondriasis
When is the average age of onset for somatic symptom disorder
20-30
Which patients have a higher prevalence of somatic symptom disorder
patients with functional disorders
-IBD
-Fibromyalgia
-Chronic fatigue syndrome
What are the 3 major DSM 5 criteria categories
Presence of 1+ physical symptom that cause significant distress
Symptoms present for 6+ months
Excessive focus on complaints
-Persistent anxiety about health must be present
What is severe somatic symptoms disorder
2-3 excessive focus indicators and multiple complaints
What are common symptoms of somatic symptom disorder
Neuropsychiatric
cardiopulmonary
GI
GU
MSK
Sensory
Endocrine
What is the prognosis of somatic symptom disorder
Can be episodic or chronic
Which patients do better with somatic symptom disorder
Sudden symptom onset
no preexisting disorders
anxiety / depression that responds to treatment
higher SES
What is conversion disorder
Characterized by medically unexplained neurologic motor symptoms
AKA: Functional neurologic symptom disorder (doesn’t include pain)
When does conversion disorder present
onset in later childhood - early adult hood
Females>Males
What patients are at higher risk for developing conversion disorder
Patient with low SES
Patients from rural areas
Patients with low education level
What are the specifiers of conversion disorder
Symptomtype
Acuity
Precipitating factors
What is the prognosis of conversion disorder
Primarily episodic
often spontaneous resolution of symptoms
What is illness anxiety disorder
Excessive worry over having or getting an illness
What are some associated symptoms of illness anxiety disorder
If symptoms present - they’re benign
focused more on the anxiety piece
What is factitious disorder
Munchausens
Intentional production of symptoms / illness
may appear medically explainable
Is Factitious disorder motivated by secondary gain
No that would be malingering
Is factitious disorder only self induced
No, can also be munchausens by proxy
When is factitious disorder present and which gender is more effected
Often present in early adulthood - middle age
males > females
Healthcare workers are at higher risk
How do you treat somatization disorders
Diagnosis of exclusion
-Rule out other medical / psych issues
Undertake a limited work-up
schedule regular visits for reoccurrence
avoid surgery / procedures / meds
What are 3 types of eating disorders
Anorexia nervosa
Bulimia nervosa
binge -eating disorder
Which gender is more effected by anorexia nervosa
Females
What is the major DSM 5 criteria for anorexia nervosa
Voluntary caloric restriction to reduce or avoid gaining weight
Symptoms present for 3+ months
What are some medical symptoms of starvation
Jaundice
Lanugo
Elevated LFTs
Muscle atrophy (inc. cardiac)
Decreased bone density
What is the BMI for someone with severe Anorexia
Less than 15
What is MANTRA therapy with anorexia nervosa
Maudsley Anorexia Nervosa Tx for Adults
-12 months and family based
Which patients get inpatient treatment with anorexia
Severe disease (20% below normal weight)
Hypotension / hypothermia
failure of outpatient treatment
What is the prognosis of anorexia
25-40% will achieve remission
What is referring syndrome
If you feed the patient too quickly / too soon can cause severe electrolyte imbalances
What is different between bulimia and anorexia
More common
20% of college girls will show symptoms
develops later than anorexia
more likely to be normal weight
What are high risk groups for bulimia nervosa
High achievers
Parental neglect
h/o depression
SUD
What are the DSM 5 criteria for bulimia
Recurrent episodes of bunge eating
recurrent inappropriate compensatory behaviors
What is severe bulimia nervosa
8-13 episodes a week
What are the subtypes of bulimia
Purging
non-purging (common with higher BMI)
What is the most common eating disorder
Binge eating disorder
What are some DSM-5 criteria for binge eating disorder
Recurrent episodes of bunge eating
three or more of the following during binge episodes
Distress during binge eating
binge eating at least 1x/wk for 3+ months
What are some medications that can be used to treat eating disorders
Fluoxetine
Vyvanse
SSRIs
