Somatic Symptom Disorders: Definitions, Types, and Treatment Strategies

What is somatization?

The expression of psychological stress through physical symptoms.

What are somatic symptom disorders?

Disorders where physical symptoms cannot be explained by underlying pathology.

Name three types of somatic symptom and related disorders.

Illness anxiety disorder, conversion disorder, psychological factors affecting other medical conditions.

What role do somatic manifestations play in a client's life?

They cause real distress and can ********************* in the client's life and relationships.

What is a common behavior of clients with somatic symptoms?

Clients often reject psychological diagnoses and seek care from multiple providers.

What are common comorbidities with somatic symptom disorders?

Anxiety and depression.

What are some risk factors for somatic symptom disorders?

First-degree relative with somatic symptom illness, decreased serotonin and endorphins, childhood trauma, and learned helplessness.

What are the three central features of somatic symptom disorders?

Physical complaints, psychological factors, and conflicts that exacerbate symptoms.

What are expected findings in clients with somatic symptoms?

Disruption of daily life, excessive preoccupation with symptoms, and anxiety about manifestations lasting longer than 6 months.

What diagnostic tests are used to rule out pathology in somatic symptom disorders?

CT scans and MRIs.

What is the Patient Health Questionnaire 15 (PHQ-15) used for?

To identify the presence of the 15 most reported somatic manifestations.

What is the focus of patient-centered care for somatic symptoms?

Accepting somatic manifestations as real, assessing for suicidal ideation, and encouraging independence in self-care.

What is reattribution treatment?

A method that helps clients identify the link between physical manifestations and psychological factors.

What are the four stages of reattribution treatment?

1. Feeling Understood, 2. Broadening the agenda, 3. Making the link, 4. Negotiating further treatment.

What medications are commonly used for somatic symptom disorders?

Analgesics, antidepressants, and anxiolytics.

What is illness anxiety disorder?

A disorder where clients misinterpret physical manifestations as evidence of a serious disease.

What behaviors are typical in clients with illness anxiety disorder?

Excessive awareness of bodily sensations, seeking multiple medical opinions, or avoiding care.

What is conversion disorder?

A functional neurological disorder where clients exhibit neurological symptoms without a neurological diagnosis.

What can trigger symptoms in conversion disorder?

Emotional or psychological stressors.

What is 'la belle indifference'?

A lack of emotional concern exhibited by some clients with conversion disorder.

What types of deficits might clients with conversion disorder experience?

Blindness, paralysis, seizures, gait disorders, and hearing loss.

What is a conversion manifestation?

A physical symptom, such as sudden blindness, that arises in response to psychological stress.

What are expected findings in conversion disorder?

Alterations in voluntary motor or sensory function, such as paralysis or blindness.

What is pseudocyesis?

A false pregnancy manifested by clients with an extreme desire to become pregnant.

What are common lab and diagnostic tests for somatic symptom disorders?

CT scans and MRIs.

What is the role of rapport in nursing care for clients with somatic symptom disorders?

Building rapport and trust helps ensure the safety of the client and encourages verbalization of feelings.

What is the expected remission rate for clients with acute stress-related symptoms?

Remission occurs without intervention in approximately 95% of clients.

What is the relapse rate for somatic symptom disorders?

The relapse rate is approximately 20%, usually within one year of initial diagnosis.

What types of medications are commonly prescribed for somatic symptom disorders?

Antidepressants and anxiolytics.

What is Factitious Disorder?

A conscious decision by the client to report physical or psychological symptoms without personal gain, except for emotional needs.

What distinguishes Factitious Disorder from Malingering?

Factitious Disorder is a mental illness, while Malingering is driven by personal gain.

What are the risk factors for Factitious Disorder?

History of emotional or physical distress, child abuse, frequent childhood illnesses requiring hospitalization, and borderline personality disorder.

What is La Belle Indifference?

An attitude of seeming lack of concern or distress about the loss of function in conversion disorder.

What are the three central features of somatic symptom illness?

Physical complaints without demonstrable organic basis, psychological factors in symptom initiation and maintenance, and symptoms magnifying health concerns not under the client's control.

What are primary gains in somatic symptom disorders?

Direct external benefits of being sick that provide relief of anxiety, conflict, and distress.

What are secondary gains in somatic symptom disorders?

Internal or personal benefits received from others because one is sick.

What nursing care should be provided for clients with somatic symptom disorders?

Discuss physical findings, assess for suicidal ideation, allow expression of feelings, and educate on coping mechanisms.

What is the significance of psychological factors in physical conditions?

Research shows a link between psychological states and physical conditions, such as heart disease and cancer.

What is the expected outcome of a confirmed medical diagnosis in relation to psychological factors?

Identification of a psychological or behavioral factor linked to the medical diagnosis.

What should be included in client education for those with somatic symptom disorders?

Participation in treatment plans, medication compliance, and attendance at therapy or support groups.

How should healthcare providers communicate suspicions of Factitious Disorder imposed on another?

Openly communicate any suspicions to the healthcare team to prevent unnecessary treatments.