W9: Somatic Symptoms & Dissociative Disorders Flashcards
What does somatic mean?
Pertaining to bodily sensations (internal and external)
What are some types of somatic symptom and related disorders
Somatic symptom disorder
Illness anxiety disorder
Conversion disorder
Factitious disorder
What is somatic symptom disorder?
When a person has a significant focus on physical symptoms, such as pain, weakness or shortness of breath, to a level that results in major distress and/or problems functioning.
What does the DSM say about somatic symptom disorder?
- 1 or more somatic symptoms that are distressing or cause disruption
- Excessive thoughts, feelings or behaviours related to the somatic symptoms or associated health concerns
- somatic symptom may not always be present, but state of being symptomatic is
Excessive focus on belief that there is something wrong with the body which may amplify normal somatic symptoms
What does somatic symptom disorder have high co-morbidity with?
Medical disorders
Anxiety disorders
Depressive disorders
What is illness anxiety disorder?
A preoccupation with having a medical illness (no symptoms) + behavioural change
May be interpreting benign symptoms as having a disorder
How is illness anxiety disorder similar to OCD
They are preoccupied which may cause anxiety to increase
Checking behaviours used to decrease anxiety
What are the two types of illness anxiety disorder?
Care-seeking type: medical care, including visiting GP, undergoing tests and procedures, is frequently used
Care-avoidant type: medical care is rarely used
What does the DSM say about illness anxiety disorder?
- preoccupation with having or acquiring a serious illness
- somatic symptoms = not present or only mild
- high anxiety around health. easily alarmed about personal health status
- performs excessive health behaviours or maladaptive avoidance
- present for at least 6 months but the feared illness can change over that time
- not better explained by other mental disorder (e.g. psychosis)
What is conversion disorder?
Functional neurologic disorders — conversion disorder — feature nervous system (neurological) symptoms that can’t be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning.
What does the DSM say about conversion disorder?
- One or more symptoms of altered voluntary movement or sensory function (e.g. numbness or seizures)
- Clinical findings provide evidence of incompatibility between the symptoms and recognised neurological or medical conditions
- The symptom or deficit is not better explained by another medical or mental disorder
- The symptom or deficit causes clinically significant distress or impairment of warrants medical evaluation
When is typical onset of conversion disorder?
Typically onset is in adolescence or early adulthood - following life stress
What is the prevalence of conversion disorder?
<1%
Are there any gender differences in conversion disorder?
More common in women
What is conversion disorder often co-morbid with?
Other somatic symptom disorders
Major depressive disorder
Substance use disorder
Why might there have been a decrease in the prevalence of conversion disorder?
May not be well diagnosed
People who have seizures that don’t follow any medical patterns are said to have pseudo seizures but it is likely a portion of these have conversion disorder
Where is conversion disorder more prevalent?
Rural areas
Low SES communities
Non-western cultures
What are some symptom type specifiers of conversion disorder
With weakness or paralysis
With abnormal movement
With swallowing symptoms
With speech symptoms
With attacks or seizures
With anaesthesia or sensory loss
With special sensory symptoms (visual, olfactory or hearing)
With mixed symptoms
What is factitious disorder?
Includes the falsification of medical and/or psychological symptoms
Intentional falsification
What are the two kinds of factitious disorder?
Imposed on self: doing things to your body to seem to have illness
Imposed on another: indicating some sort of evidence that someone else has symptoms that they don’t (e.g. actively poisoning them)
What does the DSM say about factitious disorder imposed on self?
Falsification of physical and psychological signs and symptoms, or induction of injury or disease, associated with identified deception
Presents self as ill, impaired or injured
Deceptive behaviour is evident even in the absence of obvious external rewards
Not better explained by another mental disorder (delusional or psychotic)
What does the DSM say about factitious disorder imposed on another?
Falsification of physical and psychological signs and symptoms, or induction of illness or disease in another with identified deception
Presents another individual (victim) to others as ill, impaired or injured
The deceptive behaviour evident in absence of reward
The behaviour is not better explained by another mental disorder (psychotic and delusional)