Somatization

Question 1

Risk factors for Somatoform Disorders

Answer 1

female
comorbid psychiatric dx
parents had psychiatric dx
negative life events
alexithymia 
attachment disorders
chronic or comorbid medical illness

Question 2

Somatic symptoms disorder

Answer 2

A- one or more that are distressing disrupting daily life
B - excessive thoughts, feelings related to somatic health concerns by at least one of following:
-high level of health anxiety
- disproportionate and persistent concern
- excessive time and energy devoted to these concenrs

C - chronicity , state is symptomatic > 6 months
specifiers - prominent pain
persistent

Question 3

Poor prognostic factors - somatic symptoms disorder

Answer 3

Gender (female >male)

Older age

Fewer years of education

Lower socioeconomic status

Reported history of sexual abuse (or other childhood adversity)

Concurrent disorder (mood and anxiety)

Social Stress

Reinforcing social factors (eg. secondary gain)

Concurrent medical illness

Heightened sensitivity to pain or unpleasant bodily sensation

Question 4

Conversion Disorder (Functional Neurological Symptom Disorder)

Answer 4

A - one or more symptoms of altered voluntary motor or sensory function
B- clinical findings provide evidence of incompatibility
between symptoms and recognized neurological or medical condition.
C. symptom or deficit is not better explained by another medical condition or disorder.

Question 5

Specifiers - conversion disorder

Answer 5

with weakness/paralysis
with abnormal movements
with swallowing symptoms
with attacks or seizures
with anesthesia r sensory loss
with special sensory symptoms
with mixed symptoms

acute episode < 6 months
persistent > 6 months

Question 6

What side symptoms more common -

Answer 6

Left side, especially women

Question 7

comorbidity - conversion

Answer 7

50% - MDD
30% - comorbid neurologic diagnosis
80% - epileptiform activity at some pt

Question 8

Good prognostic indicators - Conversion Disorder

Answer 8

Good premorbid functioning
Rapid onset
Clear trigger

Question 9

Tx - conversion disorder

Answer 9

1. Physician assurance
2. Gradual program of physiotherapy and expected return to function
3. Treat anything comorbid
4. LATER - explore symptoms and identify clear triggers

Question 10

Illness Anxiety Disorder

Answer 10

A. Preoccupation with having or acquiring a serious illness.

B. Somatic symptoms are not present, or if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a
medical condition, the preoccupation is clearly excessive or disproportionate.

C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.

D.The individual performs excessive health-related behaviours (eg. Repeatedly checks their body for signs of illness) or exhibits maladaptive
avoidance (eg. Avoids hospitals, etc)
E.
Illness preoccupation has been present for at least 6 months, but the
specific illness that is feared may change over that period of time.
F.
The illness-related preoccupation is not better accounted for by another
mental disorder, such as SSD, PD, GAD, BDD, OCD, Delusional Disorder,
somatic type