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| Name | Somatic symptom and factitious disorders |
| Video Uploader | Video From MedLecturesMadeEasy |
| Upload Date | This Video Uploaded At 13-06-2017 19:09:57 |
| Video Discription | This is a brief video on somatic symptom and factitious disorders. I created this presentation with Google Slides. Images were created or taken from Wikimedia Commons I created this video with the YouTube Video Editor. ADDITIONAL TAGS: Somatic symptom and factitious disorders in the DSM-5 Somatic symptom disorder Illness anxiety disorder Conversion disorder Factitious disorder Malingering Also/previously called somatoform disorder, somatization disorder At least one somatic symptom (such as pain) along with excessive fear, worry, stress, or behavioral change regarding this pain Duration of 6 months Similar to illness anxiety in the fear/stress but with actual somatic symptoms Symptom(s) is/are subconsciously driven; patients actually believe they has a disorder EPI: F M; 5-7% prevalence; risk factors include low SES, low education, older age, unemployment Prognosis: symptoms can get better or worse over time based on mood and/or stress Patients often present frustrated having seen many doctors all not believing their symptoms with many negative workups Management: Acknowledge symptoms (because they are real) Schedule regular follow-ups with a single PCP Build rapport Allows you to monitor any changes in symptoms Avoid unnecessary workup and treatment Somatic symptom disorder Somatic symptom disorder Illness anxiety disorder Conversion disorder Factitious disorder Malingering Also/previously called hypochondriasis, hypochondria, health anxiety Excessive and undue fear, worry, stress, and/or behavioral change regarding having or being diagnosed with a serious illness Duration of 6 months Somatic symptoms are absent or very minor Preoccupation with illness severely impacts their daily functioning Sometimes caused by recent psychological stressor Such as death in family → worry about same disease in self Reassurance is often ineffective Epi: M=F; ⅔ have another psychiatric illness; most prevalent in 20s-30s Management: Acknowledge concerns Schedule regular follow-ups with a single PCP Psychotherapy (CBT) Screen for comorbid anxiety and depression, consider SSRI If source is psychological stressor, resolve that stressor Also called functional neurological symptom Patient presents with at least one symptom (usually neurologic, such as numbness, blindness, mutism, or paralysis) that cannot be explained neurologically (not in normal stroke pattern) Symptom onset is usually abrupt and following significant life stress or event (death of family member, bereavement) Patient’s are often indifferent to or unconcerned with their symptom(s) La belle indifference Epi: WM; most frequent in adolescence and early adulthood Pseudoseizures, or psychogenic nonepileptic seizures, can be the symptom of conversion disorder Differentiate from epileptic seizure with prolactin level (elevated in epileptic) and EEG (normal in pseudoseizure) Management: Education about conversion disorder; reassurance that symptom will resolve Consider CBT if symptoms persist Spontaneous recovery usually occurs Also known as Munchausen's syndrome when severe Patient acts as if he has an illness by deliberately producing, feigning, or exaggerating symptoms, purely to attain a patient's role with no secondary gain or external reward Patient often creates symptoms in dangerous ways, such as injecting themselves with feces (infection) or insulin (hypoglycemia) or ingesting blood and inducing vomiting (hematemesis) Can also create less serious symptoms: abd pain, depression, hallucinations Patient can present themselves as patient or present another as a patient (Munchausen’s by proxy) Parent making child sick is child abuse Epi: WM; higher incidence in healthcare workers Management: Confront in nonthreatening manner Document and contact PCP and other providers to avoid unnecessary procedures Patient fabricates symptoms of mental or physical disorders for secondary gain or external reward Secondary gain is oftentimes getting out of work/school, obtaining drugs, clearing charges/legal record, free room and board, etc Malingering is NOT a mental illness or psychiatric pathology Oftentimes present as ill-defined, nonspecific complaints that don’t add up; often unsatisfied with reassurance or negative workup Symptoms improve once secondary gain is achieved Epi: MW; often in patients with antisocial personality disorder Management: Present the patient with discrepancies between objective findings and their subjective report Give patient opportunity to admit malingering Do not confront with hostility [n-NN8fHB_a4] |
| Category | Education |
| Tags | YouTube Editor |
