Somatic Symptom and Related Disorders

Question 1

Somatic Symptom and Related Disorders

Answer 1

​DSM 5

1. no longer somatoform dx.
2. reduces the number of disorders
3. NO MORE: somatization dx, hypochondriasis, pain disorder and undifferentiated somatoform dx

Somatic Symptom Disorder

1. Somatic symptoms plus abnormal thoughts, feelings and behaviors may or may not have a diagnosed medical condition.
2. Requires maladaptive thoughts, feelings and behavior that define the disorder in addition to their somatic symptoms.

Question 2

Medically Unexplained Symptoms

Conversion Disorder

Answer 2

Medically Unexplained Symptoms

1. DSM 5 defines disorders on the basis of Positive Symptoms (distressing somatic symptoms plus abnormal thoughts, feelings, and behaviors in response to these symptoms).
2. MUS remains a key feature in Conversion Dx and Pseudocyesis because it is possible to demonstrate that the symptoms are not consistent with medical pathophysiology.
3. Pseudocyesis: believes she is pregnant and has physical signs of pregnancy but is not pregnant

Conversion Disorder

1. aka: functional neurological symptom disorder: modified to emphasize the essential importance of the neurological examination, and relevant psychological factors may not be demonstrable at the time of diagnosis.
2. symptoms involve involuntary motor or sensory functioning and suggest a serious neurological or medical condition (paralysis, seiures, blindness, loss of pain sensation).
3. la belle indifference: lack of concern about their symptoms, while others are overly dramatic.
4. Primary Gain: symptoms keeps an internal conflict or need out of conscious awareness.
5. Seconday Gain: symptoms help the person avoid an unpleasant activity or obtain support from the environment.
6. Factitious Disorder and Maligering Dx both are voluntarily produced or feigned.

Question 3

Psychological Factors Affecting Other Medical Conditions

AND

Factitious Disorder

and

Malingering

Answer 3

Psychological Factors Affecting other Medical Conditions

1. new mental disorder to DSM 5.
2. Somatic symptoms are predominant
3. most often encountered in medical settings.

Factitious Disorder

1. presence of physcial or psychological symptoms that are intentionally produced or feigned for the purpose of fulfilling an intrapsychic need to adopt the ‘sick role’.
2. likely to present history dramatically, but vague and inconsistent in providing details. Deny when confronted with proof, and escape further evaluation.
3. often undergo numerous surgeries.
4. Factitious Disorder by Proxy (Munchausen’s Syndrome by Proxy): intentional production of physical symptoms in an individual by a caregiver.

Malingering:

1. like factitious dx, intentional production or feigning of physical or psychological symptoms, BUT the goal of the bx is to obtain an External Reward, like avoiding work/school, receiving financial compensation, or obtaining drugs.
2. should be considered if: wants medical evaluation for legal reasons, gap between symptoms and findings, uncooperative with treatment or they have Antisocial Personality Dx.