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Flashcards in 97B Somatoform Disorders Deck (13):

Somatoform disorders

Category of disorders characterized by physical symptoms with no identifiable physical cause. Both illness production and motivation are unconscious drives. Symptoms not intentionally produced or feigned. More common in women.


Somatization disorder criteria

Variety of unexplained complaints in multiple organ systems (at least 4 pain, 2 GI, 1 sexual, 1 pseudoneurologic) over a period of years, developing before age 30 years leading to lots of medical procedures


Somatization course

chronic, fluctuating with high disability and costs; eventually goes away with increasing age


typical somatization patient

all chicks under 30 with low education and low SES with a long medical hx (including suicide attempts and psych comorbidities) and lots of allergies


how to treat somatization

nonconfrontational approach
PCP should treat
Don't do invasive testing (do no harm
peer consultation (w/ another MD)
cognitive behavior therapy



Preoccupation with and fear of having a serious illness despite medical evaluation and reassurance


Body dysmorphic disorder

Preoccupation with minor or imagined defect in appearance, leading to significant emotional
distress or impaired functioning; patients often repeatedly seek cosmetic surgery



-Sudden loss of sensory or motor function (e.g., paralysis, blindness, mutism), often following
an acute stressor; patient is aware of but sometimes indifferent toward symptoms (“la belle
indifférence”); more common in females, adolescents, and young adults.
-If male then look for real medical issue
-psychiatric comorbidity common (somatoform)


management of conversion

use behavioral programs and scipts



Patient consciously fakes or claims to have a disorder in order to attain a specific 2° gain (e.g.,
avoiding work, obtaining drugs). Poor compliance with treatment or follow-up of diagnostic tests.
Complaints cease after gain (vs. factitious disorder).


Factitious disorder

Patient consciously creates physical and/or psychological symptoms in order to assume “sick role” and to get medical attention (1° gain).
Willing to undergo painful tests


Munchausen’s syndrome

Chronic factitious disorder with predominantly physical signs and symptoms. Characterized by a
history of multiple hospital admissions and willingness to receive invasive procedures.
Often in medical field


Munchausen’s syndrome by proxy

When illness in a child or elderly patient is caused by the caregiver. Motivation is to assume a sick
role by proxy. Form of child/elder abuse.