Somatoform Disorders

Question 1

list the somatoform disorders

Answer 1

1. somatization disorder
2. conversion disorder
3. hypochondriasis
4. body dysmorphic disorder
5. pain disorder
6. factitious disorder
7. malingering

Question 2

general characteristics of somatoform disorders

Answer 2

involve both unconscious and social factors that may result in primary or secondary gain. increased incidence in women, tend to start in early adulthood and worsen with stress. 50% have co-morbid mental illness like anxiety or depression. cause impairment.

Question 3

etiology

Answer 3

tend to run in families. increased incidence of hypochondriasis and pain disorder with family history of OCD or mood disorder. increased incidence of somatization disorder with a family history of antisocial personality or alcoholism. serotonin related gene pathways may be involved (usually low serotonin)

Question 4

somatization disorder

Answer 4

more than 4 pain issues (2 GI, 1 sexual, 1 neurological). cannot be explained by medical causes. onset before age 30. symptoms tend to be chronic and complete remission is rare. Unconscious, no secondary gain, patient unaware of behaviors and is concerned.

Question 5

conversion disorder

Answer 5

sudden and dramatic loss of one or more voluntary motor or sensory functions suggesting neurologic etiology. preceded by stress or conflict. Seeing something violent = blindness. patient seems unconcerned about symptoms (La belle indifference). usually self remission in 1 month. patients symptoms tend not to match the way nerves fire

Question 6

hypochondriasis

Answer 6

fear or idea of having a serious medical illness based on misinterpretation of bodily symptoms. persists despite negative findings in lab tests etc, leads to doctor shopping. symptoms must persist for more than 6 months. SSRIs may help. no secondary gain, unconscious

Question 7

body dysmorphic disorder

Answer 7

preoccupation with an imagined problem or insignificant abnormality in appearance, usually involving face or head. cannot be accounted for by an eating disorder. plastic surgery or medical interventions rarely relieve symptoms but are commonplace. no secondary gain, unconscious

Question 8

pain disorder

Answer 8

protracted pain that is severe enough to cause the patient to seek medical attention. cannot be explained by physical causes. acute or chronic (more or less than 6 months). typical age of onset is 3rd or 4th decade. can be disabling and cause dependence on pain meds. unconscious, no secondary gain

Question 9

management

Answer 9

establish strong doctor-patient relationship. identify and help decrease social stressors. SSRIs can help for hypochon, body dysmorph, and pain disorder. conversion can be treated with drug assisted interviewing (sodium barbitol). therapy can help

Question 10

factitious disorder

Answer 10

conscious feigning or production of physical or mental illness in order to receive attention from medical personnel. want to be proud and an expert and figure things out that doc cant. get angry and leave quickly when confronted. more common in people who work in med field.

Question 11

factitious disoder by proxy

Answer 11

most commonly parent feigning illness in a child to gain attention for himself. considered a form of child abuse. parent may have a history of childhood abuse/neglect.

Question 12

malingering

Answer 12

not a psychiatric illness. conscious stimulation or exaggeration of physical or mental illness to achieve some sort of secondary gain, such as disability, drugs in ER, leave of absence. symptoms improve as soon as secondary gain is obtained. seen frequently in incarcerated and people in lawsuits