Week 13 - Somatic Disorders

Question 1

What is the tendency to communicate distress through physical symptoms and pursue medical help for these symptoms?

Answer 1

somatization

Question 2

What are the four somatic symptom disorders?

Answer 2

somatic symptom disorder, Illness Anxiety Disorder, Conversion Disorder, Factitious Disorder - on self or another

Question 3

What is the DSM-5 of somatic symptoms?

Answer 3

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

Question 4

What are some specifiers of somatic symptom disorder?

Answer 4

mild, moderate, severe
predominant pain
persistent - severe sx, marked impairment, long duration

Question 5

Can you have a somatic symptom disorder with a medical condition?

Answer 5

yes

Question 6

What are common complaints of somatic symptom disorder pts?

Answer 6

localized or general pain
SOB
heart palpitations
fatigue
dizziness

Question 7

What are some common somatic complaints related to?

Answer 7

back, neck, face, chest, pelvic area, abdomen, sciatica, urinary system, muscles

Question 8

What is the DSM-5 for illness anxiety disorder?

Answer 8

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

Question 9

What does illness anxiety disorder pt have fears of?

Answer 9

contamination or taking prescription pills

Question 10

What is reading or hearing about an illness which leads to fear about the disease?

Answer 10

autosuggestibility

Question 11

What is the DSM-5 for conversion disorder?

Answer 11

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

Question 12

What are the specifiers for conversion disorder?

Answer 12

weakness or paralysis
abnormal movement
swalling symptoms
speech symptoms
attacks or szs
anesthesia or sensory loss
special sensory

Question 13

What is the DSM-5 for factitious disorder imposed on self?

Answer 13

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

Question 14

What is factitious disoder impoased on another

Answer 14

Same as self but imposed on individual

Question 15

Who is the diagnosed in factitious disorder imposed on another?

Answer 15

perpetrator

Question 16

What is deliberate production of physical or psychological symptoms with some external motivation or personal gain?

Answer 16

malingering

Question 17

How do you test to confirm malingering?

Answer 17

MMPI or neuropsychological tests

Question 18

Which illness is most prevalent?

Answer 18

illness anxiety disorder

Question 19

Who gets somatic symptom disorder more?

Answer 19

women

Question 20

What are these related to?

Answer 20

depression and anxiety, personality disorders

Question 21

How do you assess this?

Answer 21

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

Question 22

What do you avoid in treatment?

Answer 22

Avoid convincing patient that the symptoms are psychological or “in their head”
Avoid challenging patient’s pain (it’s real to them )

Question 23

What are some biological treatment for this?

Answer 23

SSRI or st john wart

Question 24

What are some CBT you can do with these pts?

Answer 24

Cognitive restructuring 
Reduce attention seeking and reassurance behaviors 
Contingency management for family 
Coping skills for stress and trauma 
Relaxation
Exposure