Somatic/Dissociative disorders

Question 1

what does dissociate mean?

Answer 1

split off consciousness to somewhere else

Question 2

somatic symptoms and related disorders: _________ symptoms without a ____________ basis

Answer 2

physical symptoms without a physiological cause

Question 3

do people with somatic symptoms have a medical cause?

Answer 3

not always, they either don’t have a medical cause with physical symptoms or do have a medical cause but their symptoms are extreme to what they should be for the condition

Question 4

somatic sxs disorder are often acute or chronic type of disorder?

Answer 4

chronic

Question 5

5 somatic sxs or related disorders

Answer 5

1) . Somatic Symptom Disorder
2) . Conversion Disorder
3) . Illness Anxiety Disorder
4) . Psychological Factors Affecting Other Medical Conditions
5) . Factitious Disorder

Question 6

what is the criteria for the state of being symptomatic for a patient diagnosed with somatic symptom disorder?

Answer 6

state of being symptomatic has to be persistent (more than 6 months)

Question 7

somatic sxs: males or females more?

Answer 7

females

Question 8

somatic sxs and related disorders: comorbid mostly with what two other disorders?

Answer 8

anxiety and depressive disorders

Question 9

4 criteria for somatic symptom disorder?

Answer 9

1) . 1 or more somatic symptom that is distressing or disrupts daily life- PT BELIEVES ILLNESS
2) . excessive thoughts, feelings or behaviors related to the symptom, manifested by disproportionate thought regarding seriousness, high level of anxiety OR excessive energy devoted to it
3) . frequently see providers and seek tx
4) . state of symptomatic is persistent (greater than 6 months)

Question 10

conversion disorder onset

Answer 10

reported throughout the lifespan

Question 11

conversion disorder: more common in males or females?

Answer 11

2-3x more common in females

Question 12

what type of psych disorder is more common in individuals with conversion disorder than in the general population?

Answer 12

personality disorders

Question 13

conversion disorder mimics what type of disorder?

Answer 13

neurological- numbness, tingling, vision problems

Question 14

4 criteria for conversion disorder

Answer 14

1). 1 or more symptoms of altered voluntary motor or sensory function
2). incompatibility between the symptom and the neuro/medical condition
3). symptom not better explained by another disorder
4). causes significant distress
PT DOES NOT FAKE SYMPTOM

Question 15

1st line tx for somatic symptom DO

Answer 15

regularly scheduled visits to healthcare provider

Question 16

specifiers for conversion disorder (7)

Answer 16

1) . weakness/paralysis
2) . abnormal movement- dystonic movement, gait disorder, tremor
3) . swallowing symptoms
4) . speech symptoms (dysphonia, slurred speech)
5) . attacks or seizures
6) . anesthesia or sensory loss
7) . special sensory symptoms (visual, olfactory, hearing)

Question 17

what is illness anxiety disorder?

Answer 17

preoccupation with having or acquiring a serious illness despite medical workups showing no disease

Question 18

is illness anxiety disorder chronic or acute?

Answer 18

usually chronic and relapsing condition

Question 19

6 criteria for illness anxiety disorder

Answer 19

1) . preoccupation with having or acquiring a serious illness
2) . somatic symptoms are not present
3) . high level of anxiety
4) . performs excessive health-related behaviors or avoidance
5) . present for at least 6 months
6) . not better explained by another disorder

Question 20

what is the essential feature of “psychological factor affecting other medical conditions”

Answer 20

presence of one or more clinically significant psychological or behavioral factors that adversely affect a medical condition by increasing the risk for suffering, death, disability

Question 21

what are some examples of psychological or behavioral factors for the “psychological factor affecting other medical conditions” disorder?

Answer 21

psychological distress, coping styles, maladaptive health behaviors (poor adherence):
i.e. anxiety affecting asthma, chronic occupational stress increasing risk for HTN, nonadherence to insulin affecting diabetes

Question 22

what is the key with diagnosis for “psychological factor affecting other medical conditions” disorder?

Answer 22

if two distinct disorders, then diagnose both

Question 23

3 criteria for “psychological factor affecting other medical conditions” disorder

Answer 23

1) . medical symptom or condition is PRESENT
2) . psych or behavioral factors adversely affect the medical condition by influencing the course of the medical condition, interfering with tx, constitute health risks OR influence underlying pathophys
3) . The factors in 2 are not better explained by another mental disorder

Question 24

two categories of factitious disorder

Answer 24

imposed on self or imposed on another (Munchausen’s by proxy)

Question 25

if personal gain is present within factitious disorder, what do you suspect?

Answer 25

malingering- exaggerate or feign illness to escape duty or work

Question 26

4 criteria of factitious disorder

Answer 26

1) . falsification of physical or psych signs, associated with identified deception FOR PRIMARY GAIN
2) . presents oneself to others as ill, injured, or impaired, may even injure oneself
3) . deceptive behavior is evidenced even in the absence of obvious external rewards
4) . not better explained by another disorder

Question 27

tx for conversion DO

Answer 27

patient education about the illness is FIRST LINE

CBT w or w/o PT

Question 28

tx for illness anxiety DO

Answer 28

regularly scheduled Drs appts and then CBT

Question 29

tx for factitious DO

Answer 29

collect info from medical providers and family to prevent unnecessary tests

Question 30

what is malingering

Answer 30

intentional falsification or exaggeration of signs and symptoms of a medical/psych illness for SEC ONDARY GAIN (money, food, shelter, school, work)