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Flashcards in liaison psych Deck (27):
1

what is somatisation disorder preoccupied with

preoccupied with SYMPTOMS

2

diagnosis somatisation

medically unexplained symptoms affecting multiple organ systems for 2 YEARS

3

common symptoms in somatisation

GI- bloating, N &V, loose stools; CVR- breathlessness, pan; GU- dysuria, freq, discharge; skin- discolouration, strange sensations

4

features somatisation

long complex medical histories. most frequently non specific and atypical.

5

aetiology somatisation

childhood illness, Hx parental anxiety to illness, incr freq in 1st degree relative, childhood sexual abuse

6

DDX somatisation

undiagnosed physical disorder, psych disorder, somatoform disorder

7

what does pt with somatisation want from the consultation

diagnosis to explain the symptoms

8

what is somatoform person preoccupied with

PAIN

9

features somatoform disorder/diagnosis

severe and distressing pain, continuous and present for most days in any part of the body for 6 MONTHS

10

what is hypochondriasis preoccupied with

diagnosis/disfigurement

11

what is hypochondriasis and how long

health anxiety. for 6 MONTHS

12

what can hypochondriasis be

overvalued fear of serious illness, or physical deformity

13

what is bodydysmorphic disorder (hypochondriac)

normal variants in appearance misinterpreted as major

14

what does a hypochondriac patient do and want at the end of consultation

reject advice and reassurance. wants the all clear

15

what treatments can be used for somatoform disorders

CBT, SSRIs 2nd line

16

what is conversion (dissociative disorder)

loss or disturbance in normal motor or sensory function

17

what does conversion appear like initially

neurological, but symptoms will be clinically inconsistent or non anatomical

18

features conversion

paralysis, speech loss, sensory loss, blind, non epileptic seizures, amnesia, fugue, stupor, trance

19

why is it called conversion

repression of the conflict and conversion to physical symptoms

20

what is fugue

dissociative state- unplanned wandering, journey from home. amnesia of personal identity

21

management dissociative/conversion

supportive psychotherapy- explain temporary condition and no long lasting physical di1sability. prognosis good if short hx symptoms. ensure no organic basis, treat any underlying mood disorder

22

secondary gain in conversion

not in diagnosis. but discuss with patient and family- is there avoidance of family conflict that is leading to maintenance of symptoms

23

how do conversion and somatoform disorders differ

conversion have signs as well as symptoms. presents more acutely

24

what is Munchausens/ factitious

deliberately feign or actually induce illness

25

what happens in health anxieties

misinterpret normal bodily sensations for illness, increase anxiety makes symptoms worse

26

when might physical illness lead to mental

medications eg steroids- depression; brain disease- depression; severe chronic illness- adjustment disorder, depression, anxiety

27

when might mental illness lead to physical

medication eg antipsychotics- metabolic syndrome; decreased self care; decr adherence to medication and other treatment eg physio; refusal to eat or drink (severe depression)