2.6 Functional disorders Flashcards Preview

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Flashcards in 2.6 Functional disorders Deck (11):
1

Some specific functional disorders:

Functional weakness
Fibromyalgia, CFS and ME
Non-epileptic attack disorder
Irritable bowel syndrome

2

(not functional disorders)

Hypochondriasis
Factitious disorder
Malingering

3

definition of functional disorder

Troublesome physical symptoms which after investigation are not fully explained by a physical disease process or injury. The symptoms are real and not imagined. Consequently, it is likely that brain activity involved in producing the symptoms is triggered by emotional change.

4

dissociative disorders- ICD-10

Dissociative amnesia
Dissociative fugue
Dissociative stupor
Trance and possession disorders
Dissociative disorders of movement and sensation

5

dissociative disorders of movement and sensation- ICD-10

Motor disorders, sensory loss and/or convulsions
Patient presents as having a physical disorder
Physical disorder doesn’t explain the symptoms
Can represent the patient’s concept of physical disorder
Usually (not always) helps the patient to escape conflict or express dependency or rejection indirectly

6

somatisation- ICD-10

Multiple, recurrent and frequently changing physical symptoms
Long and complicated history of contact with medical services
Any body part or system may be involved
Causes impairment in social and family functioning

7

somatoform disorders- ICD-10

Repeated presentation of physical symptoms
Persistent requests for medical investigations
In spite of repeated negative findings and reassurance that the symptoms have no physical basis
Usually resist attempts to discuss psychological basis
“Attention-seeking behaviour”

8

functional SPECT imaging abnormalities in functional hemiparesis

Increased activity rCBF bilaterally in frontal and parietal cortex in resting state when stimulated bilaterally when recovered
Deficit - reduced rCBF to contalateral thalamus and basal ganglia
Hypoactivation resolved with recovery
Lower degree of activation predicted a poor recovery

9

Hoover's sign

ask pt to push down on affected ankle- no effect
ask pt to lift contralateral leg against resistance- affected leg pushes down (extension)

10

non-epileptic attack disorder

10% also have epilepsy
more common in women
90% report previous traumatic experiences especially childhood abuse and/or neglect
comorbidity with depression, anxiety, PTSD
often difficult to differentiate from epilepsy- need witness account /EEG monitoring

11

hypochondriasis

not a functional disorder
called health anxiety here