Somatoform disorders

Question 1

Somatisation disorder ICD 10 criteria Briquets syndrome

Answer 1

> 2 years duration
Multiple, recurrent and frequently changing symptoms in absence of physiological explanation
-GI
-sexual/reproductive
-urinary
-neurological
Persistent refusal by patient to accept reassurance
Functional impairment
15-50% of all patients
Often dependent on sedatives and analgesia

Question 2

Hypochodriacal disorder

Answer 2

Persistent belief in the presence of at least one serious physical illness
Repeated presentations despite investigations and reassurance
Misinterpret normal body sensations
Seek a definite diagnosis

Question 3

Factitious disorder / Munchausen’s

Answer 3

Patient feigns symptoms for no obvious reason
May inflict harm on self or others
Internal motivation of adapting the sick role
1-2% of patients
Often a manifestation of psychological distress

Question 4

Malingering

Answer 4

Conscious manufacturing of symptoms for a secondary gain

Question 5

Management of somatoform disorders biological

Answer 5

Treat co morbid psych and physical conditions

Some evidence for antidepressants

Question 6

Management of somatoform disorders psychological

Answer 6

Psychoeducation
Psychotherapy
Supportive, empathetic relationship
Schedule regular appointments that are fixed

Question 7

Management of somatoform disorders social

Answer 7

Encourage them to talk about emotional problems
Only 1 or 2 Dr’s
Involve family and carers

Question 8

Somatisation definition

Answer 8

Psychological distress is expressed through physical symptoms and subsequent medical help seeking