Flashcards in Somatic Symptoms and Related Disorders Deck (86)
What is somatization?
The experiencing and communicating of emotional distress, as physical distress
What are the reasons for somatization?
-A physical symptom may be perceived as a necessary ticket of admission to receive care from a clinician
-Emotional disturbance have physical effects on the body
What are the characteristics of somatization symptoms? (3)
-Impairment in functioning is disproportionately high relative actual pathology
What is the effect of varying levels of awareness of bodily sensations?
Higher level of awareness usually means seek more care
True or false: pts with somatizations disorders often overtly deny that symptoms might relate to psychological factors
What is the usual medical h/o pts with somatization disorder? (3)
-long h/o vague symptoms
-Complementary medicine use
-Sensivity to medication
True or false: patient with somatization disorders are generally more sensitive to the side effects of the drug, but also to the main effect of the drug
False--More sensitive to the side effects, but less sensitive to the actual effect of the drug
What are the criteria for somatic symptoms disorder? (3)
-One or more somatic symptoms that are distressing, or result in disruption in daily life
-Excessive thoughts or behaviors related to the symptoms
-Symptoms may vary, but state of being symptomatic persists
True or false: psychiatric problems comorbidities are common with somatic symptom disorder
What are the three signs that a patient may have excessive thoughts or behavior related to somatic symptom disorder?
-Disproportionate and persistent thoughts about symptoms' seriousness
-persistent high levels of anxiety about health or symptoms
-Excessive time and energy devoted to symptoms
What are the criteria for illness anxiety disorder (hypochondriasis)? (4)
-Preoccupation with health to the exclusion of everything else
-Somatic symptoms are not present or mild
-High level of anxiety
-Individual performs excessive health-related behaviors
What is the major difference between somatic symptom disorder, vs illness anxiety disorder?
IAD do not have a major symptom, or it is mild--it is more a general dis-ease about their health, whereas somatic symptom disorder is much more specific and distressing
What is the duration needed to diagnose illness anxiety disorder?
What is conversion disorder? (3 criteria)
-One or more symptoms of altered voluntary motor or sensory function
-Clinical findings show incompatibility between the symptom and recognized neurological or medical conditions
What is the approach to conversion disorder?
Rather than telling the patient their symptoms are not real, can reassure that there are no serious neurological causes
True or false: conversion disorder commonly occurs in individuals who actually have related pathology
What is factitious disorder?
-Intentional production of symptoms
-Goal is to assume the sick role
How is factitious disorder different from conversion disorder?
Conversion disorder is unconscious etiology, and the patient is not knowingly portraying false symptoms, whereas factitious disorder is conscious
Is malingering a psychological disorder?
No--lying for external reward
True or false: malingering is uncommon
What is the goal behind malingering?
To obtain some other desired benefit or outcome, not the sick role itself
What is the major issue with telling a patient with somatization disorder etc that their symptoms are all in their head?
-Decreases care seeking
-Further dismisses mental disorders
What is the best way to handle pts with somatization disorder? (2)
-Have them followed by one physician, and develop a trusting relationship
-Have regular visits
True or false: you should avoid promising a cure with a pt
What is the drug category of choice for somatic symptom disorders?
Diagnostic and treatment efforts should focus on what part of the H and P with somatic symptom disorder?
Physical exam signs
What are the general features of impulse control disorders?
Problem controlling own emotions and actions, in a way that creates problems with others
What major personality trait is usually seen in impulse control disorders?
Are impulse disorders usually considered externalizing or internalizing?