Medically unexplained symptoms

Question 1

Define somatisation disorder

Answer 1

Describes the presence of physical symptoms that cannot be explained by a medical condition, drug or other mental health disorder. It is an unconscious process. Common presenting symptoms are gastrointestinal symptoms and abdominal pain, fatigue, weakness and musculoskeletal symptoms.

Question 2

Define factitious disorder/Munchausen’s syndrome

Answer 2

Patients intentionally fake signs and symptoms (e.g. adding blood to urine and complaining of pain) in order to gain attention and play “the patient role”.

Question 3

Define conversion disorder

Answer 3

A psychiatric condition that results in a presentation of neurological symptoms without any underlying neurological cause (e.g. paralysis, pseudoseizures, sensory changes). It is not an intentional process, and the symptoms are very much “real” to the patient. It is linked to emotional stress.

Question 4

Define hypochondriasis

Answer 4

Patients have excessive concern that they have a serious illness (such as cancer) despite a lack of evidence. Patients often demand unnecessary tests and investigations, and can be quite debilitated as a result of their constant worrying.

Question 5

Define malingering

Answer 5

Patients intentionally fake or induce illness for secondary gain; e.g. drug seeking, disability benefits, avoiding work or prison time.

Question 6

What is ‘la belle indifference’?

Answer 6

(Literally ‘beautiful indifference’) is associated with conversion disorder. It describes an inappropriate lack of concern over the symptoms they are experiencing. For example, a patient who is suddenly unable to walk proclaims that it is not of any worry to them.