Somatoform, Factitious, and Malingering - Vertrees

Question 1

group of illnesses characterized by physical symptoms that defy medical investigation

Answer 1

somatic symptom and related disorders

often undiagnosed

Question 2

somatic symptom and related disorders

Answer 2

somatic symptom disorder

illness anxiety disorder

conversion disorder

Question 3

somatic symptoms disorder

Answer 3

pt concerned about symptom
-distressing or disruptive

excessive thought, feeling, behavior related to it

at least 6 months

Question 4

illness anxiety disorder

Answer 4

concern about further medical issue - not focus on symptom

preoccupied with having serious disease

• no somatic symptoms
• alarmed about health status

not to be reassured

excess health related behaviors or avoidance

duration 6 months or greater

Question 5

tx of somatic sx and illness anxiety disorders

Answer 5

legitimize suffering

protect from iatrogenic harm

reinforce physician relationship without sx

Question 6

conversion disorder

Answer 6

illness or voluntary motor/sensory symptoms

symptoms unconscious

clinical findings incompatible with recognized med/neuro condition

concurrent neuro diagnosis often

Question 7

SSRI

Answer 7

in illness anxiety disorder

Question 8

meds

Answer 8

for co-morbid psych disorder in somatic symptom disorder

Question 9

person in car wreck, two people die, was driving, found - can’t move arms

Answer 9

conversion disorder

psych underlying cause

Question 10

prognosis of conversion disorder

Answer 10

present acute
resolves weeks

more in females

la belle indifference

Question 11

tx conversion disorder

Answer 11

benzos - acute tx only

book disagrees - but vertrees thinks so

Question 12

factitious disorder

Answer 12

two types:

• imposed on self
• imposed on another (munchausen by proxy)

Question 13

factitious disorder

Answer 13

voluntary production of sign, symptoms, disease

unconscious motivation

do recognize they are creating symptoms

often in medical professionals

Question 14

goal tx factitious disorder

Answer 14

obtain role of patient

primary gain - care and attention

secondary gain - tangible life benefits - make money from selling pills they get

Question 15

factitious disorder associations

Answer 15

personality
-borderline

typically young female

• high socioeconomic status
• intelligent, educated, med related fields

Question 16

factitious disorder imposed on another

Answer 16

other - child or elder

perpetrator - mother or daughter

Question 17

management of factitious disorder

Answer 17

consider pt rights/informed consent

emphasize degree of emotional distress

emphasize behavior must reflect difficulty in communicating needs

Question 18

malingering

Answer 18

intential production of sx and intentional motivation

secondary gain

• financial
• avoid military service
• avoid criminal prosecution
• obtain controlled substances
• obtain shelter

Question 19

factitious

Answer 19

conscious illness production

unconscious motive

Question 20

malingering

Answer 20

conscious illness production and motivation

Question 21

somatic symptom disorder
illness anxiety disorder
conversion disorder

Answer 21

unconscious illness production

unconscious motive

Question 22

primary psychologic gain

Answer 22

factitious

Question 23

secondary gain

Answer 23

malingering

Question 24

tx of factitious

Answer 24

supportive therapy

Question 25

lack of concern

Answer 25

conversion disorder

Question 26

conversion

Answer 26

in women - more in combat vets

Question 27

tx of conversion disorder

Answer 27

benzos, relax therapy, do nothing

Question 28

tx of conversion disorder

Answer 28

benzos, relax therapy, do nothing

Question 29

body dysmorphic disorder

Answer 29

now grouped with OCD