Week 13 - Somatic Disorders Flashcards
What is the tendency to communicate distress through physical symptoms and pursue medical help for these symptoms?
somatization
What are the four somatic symptom disorders?
somatic symptom disorder, Illness Anxiety Disorder, Conversion Disorder, Factitious Disorder - on self or another
What is the DSM-5 of somatic symptoms?
A. >1 somatic sx disrupts life
B. Excessive thoughts about sx or health >1 of:
Disproportionat and presistent thoughts about sx
high level of anxiety about health
excessive time and energy to health concerns
C. symptomatic for >6 mo
What are some specifiers of somatic symptom disorder?
mild, moderate, severe
predominant pain
persistent - severe sx, marked impairment, long duration
Can you have a somatic symptom disorder with a medical condition?
yes
What are common complaints of somatic symptom disorder pts?
localized or general pain SOB heart palpitations fatigue dizziness
What are some common somatic complaints related to?
back, neck, face, chest, pelvic area, abdomen, sciatica, urinary system, muscles
What is the DSM-5 for illness anxiety disorder?
A. preoccupation with serious illness
B. somatic sx are not present or mild in intensity
C. high level of anxiety
D. pt performs excessive health behaviors
E. illness preoccupation for 6 mo
F. not due to other disorder
What does illness anxiety disorder pt have fears of?
contamination or taking prescription pills
What is reading or hearing about an illness which leads to fear about the disease?
autosuggestibility
What is the DSM-5 for conversion disorder?
A. >1 sx of altered voluntary motor or sensory function
B. clinical finding show sx are inconsistent with known neurological or medical problem
C. not better explained
D. sx cause distress or impairment
What are the specifiers for conversion disorder?
weakness or paralysis abnormal movement swalling symptoms speech symptoms attacks or szs anesthesia or sensory loss special sensory
What is the DSM-5 for factitious disorder imposed on self?
A, false of physical and psychological signs or symptoms or induction of injury to self
B. presents self as ill, impaired
C. deceptive behavior is evident even in absence of obvious external rewards
D. behaviour not better explained
What is factitious disoder impoased on another
Same as self but imposed on individual
Who is the diagnosed in factitious disorder imposed on another?
perpetrator
What is deliberate production of physical or psychological symptoms with some external motivation or personal gain?
malingering
How do you test to confirm malingering?
MMPI or neuropsychological tests
Which illness is most prevalent?
illness anxiety disorder
Who gets somatic symptom disorder more?
women
What are these related to?
depression and anxiety, personality disorders
How do you assess this?
History of presenting problem Review pertinent medical records Physical and neurological exams Tests to confirm or rule out diagnoses Consult with psychiatry or psychology Administer screening surveys (e.g., PHQ
What do you avoid in treatment?
Avoid convincing patient that the symptoms are psychological or “in their head”
Avoid challenging patient’s pain (it’s real to them )
What are some biological treatment for this?
SSRI or st john wart
What are some CBT you can do with these pts?
Cognitive restructuring Reduce attention seeking and reassurance behaviors Contingency management for family Coping skills for stress and trauma Relaxation Exposure
