Dissociative/ Somatic

Question 1

When do dissociative events most often occur?

Answer 1

following significant trauma, esp in childhood

Question 2

What distinguishes dissociative disorders from other neurocognitive disorders?

Answer 2

-procedural memory remains intact

Question 3

What are common comorbidities assc with dissociative disorders?

Answer 3

• MDD
• PDD/dysthymia
• increased risk for suicide

Question 4

How common are dissociative disorders?

Answer 4

-6-7% more common in women

Question 5

Treatment for dissociative disorders?

Answer 5

• removal from traumatic situation

- psychotherapy

Question 6

What is dissociative fugue now a subtype of?

Answer 6

-dissociative amnesia with dissociative fugue

Question 7

Contrast depersonalization and derealization

Answer 7

• depersonalization: experiences of detachment from ones body (dejavu)
• derealiztion-detachment from ones surroundings

Question 8

How common is depersonalization/derealization disorder?

Answer 8

-2%; equal in both sexes; MC age 16

Question 9

Disorders commonly comorbid with depersonalization/derealization?

Answer 9

• anxiety

- MDD

Question 10

Treatment for depersonalization/derealization disorder

Answer 10

• CBT
• psychodynamic therapy
• hypnotherapy

Question 11

Dissociative Identity Disorder is aka?

Answer 11

-multiple personalities disorder

Question 12

Comorbidities assc with DID

Answer 12

• MDD
• PTSD
• suicide
• eating disorders
• borderline personality disorder
• substance use

Question 13

How common is suicide in DID?

Answer 13

Better than (70%) commit suicide!

Question 14

What sex more commonly experiences DID?

Answer 14

women

Question 15

Treatment for DID

Answer 15

psychotherapy
SSRIs for comorbid MDD,PTSD
-Prazosin for nightmares
-Naloxone to prevent self mutilation

Question 16

What do you call a dissociative disorder with no name that does cause distress?

Answer 16

-Other specified dissociative disorder

Question 17

Conversion d/o is aka?

Answer 17

Functional neurological symptom disorder

this helps you remember what conversion disorder IS

Question 18

How common is somatic symptom disorder?

Answer 18

5-7% population

Question 19

Criteria for somatic symptom disorder?

Answer 19

• one or more somatic complaints
• significant distress
• at least 6 months

Question 20

How to handle somatic symptom disorder

Answer 20

-regularly scheduled visits with primary care providers who minimize unnecessary medical testing

Question 21

Contrast somatic symptom disorder with conversion disorder

Answer 21

• somatic symptom= patient is severely distressed
• conversion disorder= patient has SUDDEN onset of NEURO complaint that they are often unconcerned about (blindness, paralysis, anesthesia)

Question 22

What population with conversion disorder is most likely to have a true underlying neuro deficit?

Answer 22

-elderly

Question 23

MC population w/ conversion d/o

Answer 23

• women, teens-early adulthood

- comorbid neuro, depressive, anxiety disorders

Question 24

Contrast treatment for somatic symptom and conversion disorder:

Answer 24

• conversion: provide EDUCATION about the illness + CBT +/- PT
• somatic symptom: patients more distressed, less likely to accept psych treatment, mainly try to minimize testing

Question 25

Illness Anxiety D/O criteria:

Answer 25

- 6 months - excessive health related behaviors - preoccupation with having/ acquiring a serious illness

Question 26

Illness Anxiety Disorder: | -sex + age

Answer 26

- men= women | - 20-30

Question 27

Treatment for Illness Anxiety

Answer 27

- CBT | - SSRIs for comorbid depression/ anxiety

Question 28

Contrast facticious disorder and malingering

Answer 28

``` both= conciuous creation of symptoms malingering= for external gain facticious= not for gain ```

Question 29

Facticious D/O is aka?

Answer 29

-Munchhausen (primarily physical complaints)

Question 30

What type of illness is malingering?

Answer 30

ITS NOT! | not considered a psychiatric illness

Question 31

Sex in which malingering is more common

Answer 31

men