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Flashcards in somatiform disorders Deck (32):
1

primary gain

internal, psychic motivations. patient unaware.

2

secondary gain

need housing, drugs, etc. malingering.

3

where are these more common?

women. (although equal in hypochondriasis) tend to start in early adulthood and worsen with stress.

4

are there comorbidities?

yes. 50% have comorbidities, such as anxiety and depression.

5

somatization disorder/somatic symptom disorder

there must be 4 or more symptoms: 2 GI, 1 sexual, 1 neurological, none that are adequately explained by medial history, lab tests, etc.
this is largely unconscious and the patient is unaware.

6

when is the onset of somatization?

before 30

7

are the symptoms chronic?

yes. chronic and rarely remiss

8

conversion disorder

sudden and dramatic loss of one or more voluntary motor and or sensory functions suggesting neurological etiology.
this must be preceded by psychological stress or conflict. the presenting symptom will have a symbolic representation with the stressor and serves as to decrease anxiety associated with it.. la belle indifference

9

la belle indifference

common, where the patient seems unconcerned or uninterested in the symptoms.

10

what is the course of conversion disorder?

usually self-limiting and only lasts about a month.

11

who is more likely to get a conversion disorder

psychiatrically unsophisticated and those with depression or histrionic personality

12

common motor symptoms of conversion

shifting paralysis, pseudoseizures, globus hystericus.

13

common sensory symptoms of conversion disorders

parethesis, anesthesis, vision and hearing problems.

14

common mistakes seen in conversion disorder

wrong dermatomes, blindness yet still has optokinetic effects, during seizure can sneeze or react to pain, pain radiates down instead of up, seizure head movements are vertical (not horizontal).

15

hypchondriasis

fear or idea of having a serious medical condition based on misinterpretation of physical symptoms.

16

does hypochondriasis get better with negative diagnosis

no usually persists, despite medical evidence. this leads to doctor shopping.

17

body dimorphic disorder

preoccupation with an imagined problem or insignificant abnormality in appearance.

18

what common places on the bey effects BDD

usually the head or face.

19

pain disorder

protracted pain that is severe enough for the patient to seek medical advice. there are acute and chronic features. acute is less than 6 months, chronic is greater than.

20

typical age of onset for pain disorder

30-40

21

how bad isn the pain in pain disorder

can be debilitating and cause medication dependence.

22

what are the great pretenders of medical illnesses?

depression and anxiety

23

how do we manage the somatization disorders?

strong doctor-patient relationship. regular, short appointments with constant reassurance and empathy.

24

is psychiatry typically needed with somatization

no.

25

what meds might work for somatization?

SSRIs fo depression and pain.

26

factitious disorders

munchausen syndrome. conscious feigning or production of physical or mental disorders to receive attention from medical personnel. to assume the sick role and sometimes secondary gain to feel smarter when talking with health care people.

27

how do these patients react when they are confronted

they get angry and leave quickly

28

who is more common to have a munchausen's

people who work in the medical field.

29

common symptoms in muchausen's disease

abdominal pain, fever, hematuria, seizures, skin lesion, tachycardia (drug induced), hypoglycemia (insulin injection), fever (inject feces), DVT by using ligature.

30

what can cause unconscious production of symptoms?

depression/anxiety, somatization disorders.

31

what causes conscious purposeful production of symptoms but unconscious motivation

facticious disorder

32

what causes conscious motivations and conscious production of symptoms.

malingering