Conversion Disorder
- ____ _____seizures
- Weakness and _____
- Movement disorders
- Speech disturbances (______)
- Globus sensation
- Sensory complaints
- Visual sxs
- Cognitive sxs (______)
Onset of sxs may be associated w/ ___ or _____.
- Psychogenic Non-epileptic
- Paralysis
- Slurred speech / foreign accent syndrome
- word finding difficulty, variability in speed of response
Stress or trauma
Ex of Conversion Disorder
- Woman believes not acceptable to have violent feelings, may suddenly feel numbness in arms (symptom) after becoming angry (internal conflict)
- Instead of allowing herself to have violent thoughts about hitting someone, she experiences a physical symptom of numbness in arms
Conversion Disorder
- Acute episode: present for less than ____
- Persistent: sxs occurring for more than _____
- 6 months
- 6 months
2 things you need to specify w/ Conversion Disorder
- W/ psychological stressor (specify what the stressor is)
- W/o psychological stressor
Comorbidities of Conversion Disorder
They commonly co-occur
- Anxiety disorders (esp panic disorder)
- Depressive disorders
- Substance use disorder
- Personality disorders (histrionic & dependent)
4 tx steps for Conversion Disorder
- 1st line: pt education regarding disorder w/ UTD / Functional Neurological Disorder : a pts guide AND develop therapeutic alliance w/ pt
- 2nd line: CBT & PT for pts w/ motor sxs
- 3rd line: SSRIs (off label)
- If present, tx comorbidities
Factitious Disorder was previously referred to as ____ ______.
Muchausen Syndrome
Essential feature of Factitious Disorder
- falsification of medical or psych signs & sxs associated w/ identified deception (oneself or another)
4 methods of falsification of Factitious Disorder
- Fabrication
- Exaggeration
- Simulation
- Induction
2 ways in which a pt w/ Factitious Disorder causes others to view the individual (or another) as more ill or impaired
- Deceptive behavior
- Induction of injury
Are people w/ Factitious Disorder seeking obvious external benefits
No
What is the prevalence of Factitious Disorder?
Due to secretive nature of disorder, prevalence is unknown
Factitious Disorder is more likely to occur in which 3 people?
- Females
- Unmarried individuals
- Healthcare workers
Etiology of Factitious Disorder
Uknown
Theories:
- abnormal illness behavior begins in childhood to cope w/ stress
- Establishing identity, maintaining relationships w/ others, addressing unmet emotional needs –> receiving affection is motivator
- Pts may enjoy duping clinicians
The individual presents another individual (victim) to others as ill, impaired, injured
- children
- adults
- pets
Factitious Disorder
- Use of multiple healthcare facilities
- Evasiveness in providing hx
- Refusal to grant access to info from external sources (prior medical records)
- Eagerly accepted tests/procedures
- Course of illness is unusual
Factitious Disorder
- Conscious attempt –> secondary gain —> ______
- Conscious attempt —> primary gain —> ______
- Unconscious attempt —> _____
- Malingering
- Factitious Disorder
- Somatic sx Disorder
3 comorbidities of Factitious Disorder
- Depressive disorder
- Substance use disorders
- Personality disorders (especially borderline)
1st line tx for Factitious Disorder
CBT
Why is treating pts w/ Factitious Disorder challening?
Pts often deny the diagnosis and seek tx elsewhere
– should consult/collaborate w/ mental health providers
What is considered a form of abuse
(appropriate action should be taken)
Factitious disorder imposed on another (child or adult)
