Which of the following disorders are characterized by unconscious production of physical symptoms that are not explained by a medical condition? Somatization Disorder Malingering Conversion Disorder Anxiety/Depression Factitious Disorder
Somatization Disorder
Conversion Disorder
Anxiety/Depression
Which of the following disorders are characterized by conscious production of symptoms with an unconscious motivation? Somatization Disorder Malingering Conversion Disorder Anxiety/Depression Factitious Disorder
Factitious Disorder
Which of the following disorders are characterized by conscious production symptoms with a conscious motivation? Somatization Disorder Malingering Conversion Disorder Anxiety/Depression Factitious Disorder
Malingering
What is primary gain?
internal motivations
What is secondary gain?
external motivations
In which sex is there a higher incidence of somatoform disorders?
women
When do somatoform disorders usually start and what makes them worse?
starts in early adulthood
worse with stress
Are somatoform disorders genetic?
somatization, hypochondriasis and pain disorder do tend to run in families
What is the suggested biological pathway for somatoform disorders?
serotonin-related pathways
What are the diagnostic criteria for somatization disorder?
> 4 pain issues-2 GI, 1 sexual, 1 neuro
onset before 30
Sx are chronic and complete remission is rare
Unconscious/ no secondary gain
What are the diagnostic criteria for conversion disorder?
- sudden loss of 1+ voluntary motor or sensory fxns
- preceded by psychological stress or conflict
- Sx usually has a symbolic relationship with the stressor
- “La belle indifference”- pts seem unconcerned about their sx
- unconscious/ no secondary gain
How long does conversion disorder usually last?
<1 month usually self limited
What are the diagnostic criteria for hypochondraisis?
- fear/idea of having a medical illness
- persists despite negative findings (dr shopping)
- Sx for >6 months
- unconsciouns/ no secondary gain
What type of medication may help in treating hypochondriasis?
SSRI’s
What are the diagnostic criteria for body dysmorphic disorder?
- preoccupation w/ imagined problem or insignificant abnormality in appearance (usually face/head)
- can’t be accounted for by eating disorder
- Plastic surgery rarely relieves sx
- unconscious/no secondary gain
What are the diagnostic criteria for pain disorder?
- pain severe enough to cause pt to seek medical attention
- can’t be explained by physical causes
- acute 6 months
- onset in 3rd or 4th decade
- can be disabling and cause dependence on meds
- unconscious/no secondary gain
What is the differential diagnosis for any of the unconscious somatoform disorder?
- true illness
- depression or anxiety
- conscious somatoform disorder (factitious disorder or malingering)
Is psychiatry usually needed to treat the unconscious somatoform disorders?
no
How are the unconsicous somatoform disorders usually treated?
- identify and decrease stressors and primary gain
- treat anxiety/depression if present
- drug assisted interviewing with Na amobarbital
- Hypnosis
- Psychotherapy, interpersonal and CBT
What are the diagnostic criteria for factitious disorder?
-conscious feigning or production of physical /mental illness to receive attention from medical personnel
What is the primary gain in factitious disorder?
feel safe and cared for
What is the secondary gain in factitious disorder?
feel proud/ an expert to be able to figure things out that drs cant
What happens when people with factitious disorder are confronted?
get angry and leave quickly
In what field is factitious most common?
medical field
