Term
| What is the definition of a somatoform disorder? |
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Definition
| -pts present with physical sxs that have no organic cause; they truly believe that their sxs are due to medical problems and are not consciously feigning sxs
-patients are not consciously aware of gains and do not intentionally seek them |
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Term
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Definition
| Expression of unacceptable feelings as physical symptoms in order to avoid facing them |
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Term
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Definition
| Use of sxs to benefit the patient (increased attention from others, decreased responsibilities, avoidance of the law) |
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Term
| A middle-aged woman c/o numerous sxs involving several organ sxs. She has been unwell or "sickly" since early adulthood and describes herself as suffering. She is resistant to psychiatric referral. |
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Definition
| Somatization d/o
Criteria:
-at least 2 GI sxs
-at least 1 sexual/reproductive sx
-at least 1 neuro sx
-at least 4 pain sxs
-onset before age 30
-can't be explained by general medical condition or substance abuse
*half of patients will have comorbid mental disorder
-tx: regularly scheduled and frequent visits; pts will usually refuse psych visit; minimize secondary gain; use medication with caution |
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Term
| 20 y.o. woman states that she has been blind since yesterday. She seems calm and indifference. The blindness began 1 week following her son's death. Her neurological exam is normal, retinal exam is normal. |
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Definition
| Conversion disorder
Criteria:
-At least one neurological sx
-psychological factors ass'd with initiation or exacerbation
-sx not intentionally produced
-can't be explained by substances, medical conditions
-not accounted for by somatization, mental disorder
-not limited to pain or sexual sx
-Ddx: must r/o underlaying medical cause (50% will have medical dx eventually)
-prognosis: most sxs resolve within 1 month
-tx: insight-oriented psychotherapy, sodium amobarbital assisted interview |
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Term
| 30 y.o concerned about colon cancer. Has had intermittent abdominal pain for the past year and has seen several doctors. He had multiple studies, all normal, but after each test he was worrying a short time after he was told they were normal. On this visit, records reveal all normal findings. He is resistant to seeing a psychiatrist |
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Definition
| Hypochondriasis
-prolonged, exaggerated concern about health and possible illness. Patients fear having a disease or are convinced that one is present
-Criteria:
*fear that they have a serious medical condition based on misinterpretation of normal bodily sxs
*fears persist despite nl appropriate evaluation
*fears present for at least 6 months
-Ddx: vs. somatization disorder (somatization pts are concerned about their symptoms, whereas hypochondriacs are worried about disease
-tx: frequently scheduled visits to one primary care doctor; patients are resistant to psychotherapy |
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Term
| A 20 y.o. female wants a nose job because her nose is huge and ugly. She thinks everyone stares at her huge,ugly nose. Nose looks normal to you. After the rhinoplasty, she still hates her nose |
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Definition
| Body dysmorphic disorder
-Criteria
*preoccupation with an imagined defect in appearance or excessive concern about a slight physical anomaly
*Must cause significant distress in the patient's life
-Epidemi: more common in unmarried women, patients often have coexisting psychiatric dz
-Tx: SSRIs reduce sxs in 50% of patients |
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Term
| 40 y.o. female referred to ortho for severe ankle pain following a minor injury while playing tennis 10 months ago. All relevant studies are normal. |
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Definition
| Pain disorder
-Criteria
*pts have prolonged severe discomfort without adequate medical explanation
*pt's main concern is pain at one or more anatomical sites
*pain related to psych factors
-must rule out underlaying medical condition, hypochondriasis and malingering
-Tx: analgesics are not helpful (addition common); SSRIs, transient nerve stimulation, biofeedback, therapy may be useful |
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Term
| A 30 y.o. male lab asst. is admitted for fever and bacteremia. The patient needs a central venous catheter because of poor access. blood cx reveal unusual orgs in the blood and a total of 8 different organisms are isolated. Patient's bathroom has many syringes on the floor. When the patient is confronted with the hypothesis that he has been injecting himself with dirty needles, he signs out of the hosptial. |
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Definition
| Fictitious d/o
Criteria:
*intentional production of physical or mental d/o's
*They produce sxs to assume the role of the patient
*there are no external incentives (i.e. monetary compensation)
*either predominately psych or predominately physical (Munchausen syndrome) complaints
tx: no effective treatment, but avoid unnecessary procedures and maintain a close liaison with the patient's primary doctor; patient usually leave hospital once confronted |
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Term
| Feigning of physical or psychological sxs in order to achieve personal gain. (secondary gain) |
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Definition
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