Somatic Disorders

Question 1

somatic symptoms (general)

Answer 1

• physical symptoms that are INCOMPATIBLE with a neurological or general medical condition
• symptoms are NOT produced voluntarily
• high utilization of medical services
• resist being seen by psychiatrists
• NOT EXPLAINED BY A MEDICAL CONDITION (dx of exclusion)

Question 2

somatization

Answer 2

• culturally acceptable form of psychosocial stress
• somatizers have a lower threshold for reporting sx
• puts ppl at risk for iatrogenic morbidity

Question 3

somatic symptom disorders kept in the new DSM-V

Answer 3

• somatic symptom disorder
• illness anxiety disorder
• conversion disorder
• factitious disorder
• body dysmorphic disorder

Question 4

somatic symptom disorders not used anymore (DSM-IV)

Answer 4

• somatization disorder
• pain disorder
• hypochondriasis
• somatoform NOS
• undifferentiated somatoform

NOT USED ANYMORE

Question 5

lack of medically explained symptoms ___________

Answer 5

lack of medically explained symptoms DO NOT EQUAL A PSYCHIATRIC DIAGNOSIS

Question 6

somatic symptom disorder (SSD) key criteria

Answer 6

1) one+ distressing somatic symptoms that cause major daily life disruptions
2) excessive thoughts, feelings, or behaviors about these sx, characterized by at least 1 of the following:
- persistent high anxiety about health/sx
- disproportionate/persistent thoughts of seriousness of sx
- excessive time/energy devoted to sx
3) time: > 6 months

Question 7

illness anxiety disorder (IAD) key criteria

Answer 7

1) preocupation with having a serious illness
2) somatic sx are not present (or mild)
3) high level of anxiety about health, easily alarmed by personal health status
4) excessive health related behaviors or maladaptive avoidance
5) >6 months (but feared illness may change over time)

Question 8

conversion disorder (CD) key criteria

Answer 8

• requires clear evidence of incompatibility with neurological disease
  1) 1+ sx of altered voluntary or sensory function
  2) evidence of incompatibility btwn sx and neurological/medical conditions
  3) not better explained
  4) causes significant distress/impairment

ACUTE: <6 mos
CHRONIC >6 mos

Question 9

acute vs chronic CD

Answer 9

CD = conversion disorder

acute: < 6 mos
chronic: >6 mos

Question 10

30% of pts diagnosed with ___________ eventually develop organic condition that explains conversion sx

Answer 10

30% of pts diagnosed with CONVERSION DISORDER eventually develop organic condition that explains conversion sx

Question 11

neurologic disorders misdiagnosed as conversion disorder

Answer 11

• MS
• myasthenia gravis
• dystonia

Question 12

psychological factors affecting other medical conditions (PFAOMC)

Answer 12

1) a medical sx or condition must be present
2) psychological or behavioral factors adversely affect the medical condition (influence the course, or interfere w the treatment, or add additional health risks, or exacerbate the sx)
3) not better explained by another mental disorder (PTSD, panic disorder, MDD)

Question 13

PFAOMC severity criteria

Answer 13

Mild
-increases medical risk inconsistent coherence

Moderate
-aggravates medical condition, anxiety, asthma

Severe
-results in ED or hospital admission

Extreme
-results in severe life threatening risk

Question 14

examples of PFAOMC

Answer 14

• long term work stress and hypertension
• anxiety and asthma
• depression and CAD
• alcohol use d/o and liver disease
• smoking and COPD
• obesity and diabetes

Question 15

body dismorphic disorder (BDD) key criteria

Answer 15

1) preoccupation with 1+ flaws NOT observable to others
2) causes clinically significant distress or impairment
3) perform repetitive behaviors or mental acts (compare self to others)
4) not better explained concern w/ body weight that meet criteria for eating disorder

Question 16

which somatic symptom disorder can be treated with medication?
what medication is used?

Answer 16

body dysmorphic disorder

Tx: SSRIs and CBT

Question 17

facticious disorder imposed on self

Answer 17

• falsification of symptoms
• presents themselves as ill, impaired, or injured
• deceptive behavior is present in absence of external rewards
• not better explained

Question 18

facticious disorder imposed on others

Answer 18

• falsification of sx
• presents another individual (victim) as ill, impaired, or injured
• absence of external rewards
• not better explained
• PERPETRATOR receives diagnosis

Question 19

pseudocyesis

Answer 19

partner gets sx of pregnancy