Unit 4 cont'd: Somatoform Disorders Flashcards
What are SOMATOFORM DISORDERS?
an extreme focus on physical symptoms — such as pain or fatigue — that causes major emotional distress and problems functioning
What is SOMATIC SYMPTOM DISORDER?
a disorder characterized by one or more bodily symptoms that are distressing to the individual, result in a significant disruption of daily life, and are accompanied by excessive worry and preoccupation, extreme anxiety, or disproportionate time and energy
What is the DSM-5-TR diagnostic criteria for somatic symptom disorder?
1) 1 or more symptoms that are distressing or result in significant disruption of daily life
2) Excessive thoughts, feelings or behaviours related to the somatic symptoms or associated health concerns as manifested by at least 1 of the following: disproportionate and persistent thoughts about the seriousness of one’s symptoms; persistently high level of anxiety about health or symptoms; excessive time and energy devoted to these symptoms or health concerns
3) Although any 1 symptom may not be consistently present, the state of being symptomatic is persistent (6+ months)
What are possible outcomes of medical examinations for people with somatic symptom disorder?
a medical examination sometimes leads to the discovery of a genuine disease, but the individual’s level of anxiety and functional impairment continue to be in excess of what is normal or realistic for this health concern
more often, no serious medical condition is found, but the patient is not reassured and may become resentful, feeling that their doctor is not taking them seriously; patients tend to strongly resist the implication that their illness may be psychological or related to social factors
What are some common features of patients with somatic symptom disorder?
personal identity may be wrapped up in their perceived illness
frequently visit the physician or hospital
may describe their problems in an exaggerated manner, but without specific factual information
often prone to anxiety and depression that they cannot effectively cope with or express
often display excessive sensitivity to relatively minor bodily symptoms
What are the similarities and differences between panic disorder and somatic symptom disorder?
both involve excessive concern and misinterpretation of bodily symptoms
those with panic disorder typically fear the immediate symptom related disasters; those with somatic symptom disorder focus on the long term process of illness and disease
What is the most commonly reported symptom by patients with somatic symptom disorder?
pain
pain disorder was previously a separate diagnosis but has been subsumed by somatic symptom disorder
31% of the population has experienced chronic pain; when pain persists beyond its expected time, psychological factors should be considered
What is FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDER (conversion disorder)?
a mental disorder characterized by neurologic symptoms (either sensory or motor) that is incompatible with any known neurological disease
What are the common symptoms of conversion disorder?
weakness and/or paralysis
non-epileptic seizures
movement disorders
speech or visual impairment
swallowing difficulty
sensory disturbances
cognitive symptoms
What is the DSM-5-TR diagnostic criteria for conversion disorder?
1) 1 or more symptoms of altered voluntary motor or sensory function
2) Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions
3) The symptom or deficit is not explained better by another medical or mental disorder
4) The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, or warrants medical evaluation
Why is it essential to complete a careful medical evaluation of patients with suspected conversion disorder?
to ensure a genuine medical condition is not misdiagnosed
DSM-5-TR criteria stipulates that this disorder can only be diagnosed after thorough medical testing provides clear evidence that the symptoms are not compatible with a neurological disease
What are some features clinicians are looking for when diagnosing conversion disorder?
EEG recordings that may show that a patient’s seizures are not accompanied by the distinctive brain wave pattern detected in epilepsy
inconsistencies over time: inadvertently moving a “paralyzed” limb when attention is redirected; unusual symptom patterns
symptoms that are clearly inconsistent with known psychological mechanisms
What do fMRI images suggest may cause conversion disorders?
a dynamic reorganization of the brain circuits that link volition, movement, memory, and perception, leading to an inhibition of normal cortical activity
How are conversion disorders and dissociative disorders related?
these were previously grouped together under the label “hysteria”
some experts say that conversion disorders involve a process of dissociation in which there is a lack of integration between conscious awareness and sensory processes or voluntary control over physical symptoms
individuals with conversion disorders often meet the criteria for diagnoses of dissociative disorders, have high scores on measures of dissociative experiences and a history of child abuse/trauma
What is ILLNESS ANXIETY DISORDER?
applies to the subset of people who previously would have been diagnosed with hypochondriasis
individuals who are preoccupied with fear that they may have a serious illness, despite the fact that thorough medical examination reveals nothing seriously wrong with them
