Unexplained Symptoms Flashcards
are unexplained symptoms common?
yes
- 50% of GP patients
give some examples of unexampled symptoms ?
poor memory poor concentration headaches altered sense of taste altered sense of smell tinnitus dizziness funny turns fatigue weakness tingling pain
what three things may cause a disturbance between symptoms and underlying pathology?
mood
emotion
behaviour
what is the sick role ?
when someone is ill
- they are exempt from social norms
- not responsible for their condition
- person should want to get well and seek medical advice
what is illness behaviour ?
different perceptions people have about illnesses and symptoms
- symptom significance and perception
- consultation behaviour
- treatment compliance
what two things are patients with unexplained symptoms more likely to do?
more likely not to have a job
more likely to be on benefits
is there is close relationship between physical and psychological symptoms ?
yes
state three physical manifestations of anxiety ?
autonomic - sweating, palpitations, dizziness increased motor tone - tremor, muscle pain hyper vigilance - poor concentration, insomnia, easily startled
state three physical manifestations of depression ?
sleep weight appetite libido energy levels posture pain perception
is parkinsons relapsing or progressively worsening ?
progressively worsening
what is hypochondriasis?
fear of illness
persistent belief of unidentified disease
request for repeated reassurance
request for repeated investigation
what is a good question to ask someone of depression ?
do your symptoms get you down?
what is a good question to ask someone of anxiety ?
do you get worried about your health
what is somatisation disorder?
abnormal illness behaviour
- chronic symptoms and multiple unexplained symptoms
what is conversion disorder?
loss of function which can mimic neurological disease
- patients isn’t conscious of mechanisms
what is malingering ?
loss of function which can mimic neurological disease
- patient is conscious of mechanisms
in what communities does malingering occur?
institutions
- boarding schools, strict religions
- compensation patients
what are the multiple physical symptoms of chronic fatigue syndrome?
fatigue
arthralgia
myalgia
what percentage of people with chronic fatigue syndrome have a psychiatric diagnosis ?
70%
what are some risk factors for non-epileptic attack disorder?
abuse neglect in childhood anxiety depression post traumatic stress disorder
what is the management of unexplained symptoms ?
exclude physical disease carry out investigations and avoid over investigating psychiatric assessment explantation to patient MDT approach consider antidepressant drugs consider cognitive behavioural therapy
