somatic symptom disorders

somatic symptom disorder key diagnostic criteria

one or more distressing somatic symptoms

excessive thoughts related to the symptoms with at least one of disproportionate and persistent thoughts, anxiety about health, or excessive time/energy devoted to symptoms

symptomatic in some form for at least 6 months

how to distinguish somatic symptom disorders

ineffectiveness of pain relievers

history of mental disorders

unclear provocative/palliative factors

persistance without stopping

stress

assessment tools for somatic symptom disorder

PHQ-15

somatic symptom scale

wellbeing scale

somatic symptom disorder is a diagnosis of

exclusion

CARE MD acronym for somatic symptom/illness anxiety treatment

consultation/collaboration

assessment

regular visits

empathy

medical/psychiatric interface

do no harm

somatic symptom disorder treatment

antidepressants only for treatment resistant, prominent anxiety/depressive/OCD symptomsi

illness anxiety disorder key diagnostic criteria

preoccupation with having or acquiring a serious illness (not symptoms)

somatic symptoms not present

excessive (maladaptive) health related behaviors

preoccupation for at least 6 months

origin of distress for illness anxiety disorder

anxiety about the meaning of the possible illness NOT the complaint itself

assessment for illness anxiety disorder

whiteley index

illness attitudes scales

illness anxiety disorder treatment

1st - CBT

2nd - other psychotherapy

3rd - antidepressant (avoid)

conversion disorder key diagnostic criteria

altered voluntary motor or sensory function

incompatibility between symptom and recognized conditions

conversion disorder key features

symptoms are NOT controlled at will or feigned

how to differentiate conversion disorder

drop arm test

non-anatomic sensory loss (use dermatomes)

mismatch between physical tests

psychogenic nonepileptic seizures

physiologic distress manifests as episodes that resemble seizures but are not caused by electrical dysfunction

conversion disorder treatment

1st - education about diagnosis

2nd - physical therapy and CBT

3rd - medications

factitious disorder key diagnostic criteria

falsification of signs/symptoms or induction of injury/disease

deceptive behavior even without obvious external rewards

factitious disorder treatment

CBT

factitious disorder imposed on another key diagnostic criteria

falsification of signs/symptoms or induction of injury/disease in another person

presenting another individual to others as ill

deceptive behavior even without obvious external rewards

factitious disorder imposed on another key features

illness abates when separated from imposer

phsiological findings consistent with induced illness

suspected disease is rare