Somatoform Disorders - Carlson

Question 1

T/F: overworkup of somatoform disorders is common

Answer 1

true

Question 2

what dz’s must you rule out when thinking about somatoform disorders?

Answer 2

Multiple sclerosis
Systemic lupus erythematosus
Acute intermittent porphyria
Myasthenia gravis
A. L. S.

Question 3

what psych issues must you rule out when working with somatoform disorders?

Answer 3

Delusional disorders
Affective disorders
Anxiety disorders

Question 4

what is the age of onset for Dx of somatic symptom disorder?

Answer 4

before thirty

Question 5

which gender is more likely to have a Dx of somatic symptome disorder?

Answer 5

females

Question 6

what are the areas of findings needed to Dx somatic symptom disorders?

Answer 6

4 pain
2 gastrointestinal
1 sexual
1 pseudoneurological

Question 7

What are the DSM5 criteria for the length of time spent on somatic symptom disorder?

Answer 7

6 months; excessive time and energy spent, disproportionate thoughts regarding symtpoms

Question 8

What are the other names for somatic symptom disorder?

Answer 8

Briquette’s Syndrome
Hysteria
Somatization disorder

Question 9

males with a female relative with hysteria have what psych risk factors?

Answer 9

increased risk of somatization disorder, antisocial personality disorder, substance abuse disorders

Question 10

What two disorders are more than 2x more likely in hysteria?

Answer 10

depression

GAD

Question 11

What specific past Hx increases the likelihood of hysteria?

Answer 11

past physical and sexual abuse

childhood illness or family member with chronic illness

Question 12

what is the MSE like in hysteria?

Answer 12

presentation dramatic, vague, complicated, seductive, manipulative and emotional
Symptoms fluctuate with stress

Question 13

What are the complications of somatic symptom disorder?

Answer 13

Unnecessary surgical procedures
Drug dependence
Suicide attempts
Relationship problems

Question 14

what Tx should you be careful with when treating somatic symtpom disorder?

Answer 14

invasive procedures and addictive meds

Question 15

what is conversion disorder?

Answer 15

Symptoms or deficits affecting voluntary motor or sensory system
Blindness, paralysis, dysphonia, seizures

Question 16

what is conversion disorder brought on by?

Answer 16

stress

Question 17

glove anasthesia is a form of…

Answer 17

conversion disorder

Question 18

conversion disorders onset in which gender and age group?

Answer 18

10-35 in females

prevalence decreases with sociocultural dev and knowledge

Question 19

conversion disorder may evolve into…

Answer 19

somatic sx disorder in females

Question 20

conversion disorder is assc’d with what personality disorder in males?

Answer 20

antisocial personality disorder

Question 21

T/F: a brief duration with recurrence in common in conversion disroder

Answer 21

true

Question 22

What types of conversion disorder have better prognosis?

Answer 22

paralysis, aphonia, and blindness

worse with tremor and seizure

Question 23

how do you manage conversion disorder?

Answer 23

Supportive Psychotherapy
Determine stressor(s)
Help patient problem solve
Positive expectations
R/O treatable medical conditions

Question 24

what are the criteria for illness anxiety disorder?

Answer 24

preoccupation with fears of having a serious disease; not delusional; preoccupation persists after workup and reassurance

Question 25

does illness anxiety affect only females?

Answer 25

both sexes equally

Question 26

is illness anxiety relapsing?

Answer 26

yes, and chronic

Question 27

what is the effect of SES on illness anxiety?

Answer 27

higher SES=better prognosis

Question 28

What is the clinical picture like in illness anxiety?

Answer 28

Fears having a serious illness related to a single body sensation History of doctor shopping Brings problem lists Doubts physician competence

Question 29

how do you treat illness anxiety?

Answer 29

``` develop trusting relationship R/O actual illness do brief physical at every meeting establish stress-illness connection consider SSRI supportive psychotherapy ```

Question 30

Describe symptom scheduling for illness anxiety?

Answer 30

track primary symptom four times daily at spcecific times track anxiety and pain attempt to determine causal relationship between the the two do it the first time in office

Question 31

What is factitious disorder?

Answer 31

conscious awareness of what they are doing; actively playing the sick role

Question 32

Can you have physical symptoms in factitious disorder?

Answer 32

yes

Question 33

What are the facets that makes factitious disorder an actual disorder?

Answer 33

Maladaptive (can be life threatening) Motivation unclear to patients Often underlying personality disorder May respond to treatment intervention

Question 34

what is munchausen by proxy?

Answer 34

medical child abuse in which the parent fakes the illness of the kid

Question 35

what is the difference between malingering and factitious disorder?

Answer 35

malingering has a clear external incentive like drugs or avoiding jail time

Question 36

do men or women malinger more?

Answer 36

men

Question 37

``` Is this factitious or malingering? borderline personality pursue painful tests varied symptoms chronic ```

Answer 37

factitious