Session 09 - Medically Unexplained Symptoms Flashcards
What is somatisation disorder?
A disorder where patients believe they have physical symptoms present for at least 2 years, despite no physical or organic explanation.
The most common symptoms are mostly abdominal pain and involving the skin.
Patients don’t accept negative test results and instead feel distress and worry over their symptoms.
What is hypochondrial disorder?
This is a disorder where patients believe they have a serious underlying disease (e.g. HIV, AIDS), despite there being no physical or organic explanation.
Patients don’t accept negative results, and instead feel great distress and worry.
What is the difference between somatisation disorder and hypochondrial disorder?
Somatisation disorder: physical symptoms; more common in young women.
Hypochondrial disorder: underlying disease; more common in men and people who have more contact with disease (e.g. healthcare workers).
What is dysmporphophobia?
A preoccupation with imagined or small defect in physical appearance, causing physical distress, anxiety and avoidance behaviour.
For example, patients can become worried about the size of their nose, even though it is a normal size.
What is conversion disorder?
A condition where the patient exhibits loss of motor or sensory function (e.g. paralysis or numbness), despite there being no physical or organic cause.
The patient doesn’t consciously fake the symptoms or try to exaggerate them, but believes they are real.
Management is to exclude organic causes, then therapies such as hypnosis, psychotherapy, stress management.
What are dissociative disorders?
A group of conditions involving disruptions or breakdowns in memory, awareness, identity or perception.
This causes psychiatric symptoms to occur in absence of pathology.
What is dissociative amnesia?
A condition where a patient has no recollection of upsetting and personal information.
Seen as a way to cope with previous emotional trauma.
What is dissociative fugue?
A form of dissociative amnesia in which the patient flees away from their home.
They display amnesia for their identify, memories and personality; lasting from hours to days.
What is dissociative identity disorder?
The most severe form of dissociative disorder.
The patient develops multiple personalities which can take over, and have amnesia for when the different personalities take over.
It is strongly linked to early childhood trauma (e.g. sexual abuse).
Management of dissociative disorders.
- Exclude organic causes.
- Psychotherapy (e.g. hypnosis)
What is factitious disorder?
A condition where patients will produce physical or psychological symptoms to attain a patient’s role.
Patients can fake the symptoms, exaggerate them or deliberately hurt themselves to produce symptoms.
They may take hallucinogens, inject faeces to make abscesses or contaminate urine samples.
Management of fascitious disorder.
Psychotherapy is first line.
Family is also taught to condemn, not reward the behaviour.
What is malingering?
When a patient fakes or exaggerates their symptoms due to financial reward or gain.
It is not to play a patient’s role but to receive compensation, personal damages or get off work.
It is not a medical diagnosis, but can produce a large economic burden on healthcare systems.
