Flashcards in 97B Somatoform Disorders Deck (13):
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
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
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).
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
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