[10.18] Other Non-Psychotic Disorders V2.pdf

Mental disorders without any form of psychosis

What is the definition of non psychotic disorders?

Somatic symptoms with significant distress and impairment in functioning

What is the common feature of somatic symptom and related disorders?

Genetic and biological vulnerability, early traumatic experiences, learned behavior, and cultural and social norms

What are the four contributing factors for somatic symptom and related disorders?

Somatic Symptom Disorder

Which disorder was previously called hypochondriasis according to Dr. Espinosa Rondain?

Illness Anxiety Disorder

Which disorder was previously termed as hypochondriasis according to Dr. Maddatu Pajarillo?

Doctor shoppers

What term describes patients who visit different doctors to find one who agrees with their perceived illness?

Somatic Symptom Disorder

In which disorder does a patient have one or more distressing physical symptoms like diarrhea or chest pain despite normal tests?

Persistent typically more than 6 months

How long must the symptomatic state last for a somatic symptom disorder diagnosis?

Medical insurance

Patients with SSD may finish their allotted coverage especially if they have what?

5 percent to 7 percent

What is the estimated prevalence of SSD in the general adult population?

Females

Somatic symptom disorder has a higher prevalence in which gender?

Cardiologists, pulmonologists, or surgeons

Most referrals for SSD come from which types of specialists?

Alterations in the processing of information from somatic sources

What is a biological feature that may lead to SSD?

Childhood abuse

What psychosocial experience may predispose a person to SSD later in life?

Distinguishing legitimate symptoms from somatized complaints

What is a crucial step in the biological treatment of SSD?

Coordination by one physician

What is the preferred approach for psychosocial treatment of SSD?

Development of a vocabulary for expressing feelings

Searching for the emotional component in symptom formation helps patients with what?

PAINS

What is the mnemonic for the diagnosis of SSD?

Physical complaints are in excess of actual medical conditions

In the PAINS mnemonic what does the P stand for?

Age of onset under 30 years old

In the PAINS mnemonic what does the A stand for?

Investigations do not reveal a cause for the complaints

In the PAINS mnemonic what does the I stand for?

Not due to malingering or factitious disorder

In the PAINS mnemonic what does the N stand for?

Social occupational or academic functioning is affected

In the PAINS mnemonic what does the S stand for?

Malingering

What term refers to consciously producing a symptom for secondary gain like an excuse from work?

Factitious disorder

What term refers to complaining of symptoms where the secondary gain is not obvious or the patient is unaware of it?

Unconscious trauma from the past

Why do patients with SSD believe they are sick even without primary or secondary gain?

Illness Anxiety Disorder

Which disorder involves preoccupation with having or acquiring a serious illness like cancer or lupus?

Obsession with being sick

What type of obsession do IAD patients exhibit?

IAD involves preoccupation with a serious illness while SSD involves complaints of specific symptoms

What is the difference between IAD and SSD regarding patient complaints?

Somatic symptoms are not present or are only mild in intensity

What is the intensity of somatic symptoms in illness anxiety disorder?

High anxiety

What is the main mood of the illness for patients with IAD?

Difficulty functioning

Patients with IAD perform excessive health related behaviors or avoidance leading to what?

At least 6 months

How long must the illness preoccupation be present for an IAD diagnosis?

1 percent to 10 percent

What is the prevalence range of IAD in the medical population?

Chronic and relapsing

What is the typical development and course of IAD?

Early to middle adulthood

What is the age of onset for illness anxiety disorder?

DRIPS

What is the mnemonic for symptoms of IAD?

Delusional intensity of thoughts is not present

In the DRIPS mnemonic what does the D stand for?

Reassurance does not lessen concern

In the DRIPS mnemonic what does the R stand for?

Impairment in social or occupational functioning

In the DRIPS mnemonic what does the I stand for?

Preoccupation with the idea of having a serious illness

In the DRIPS mnemonic what does the P stand for?

Six month minimum duration

In the DRIPS mnemonic what does the S stand for?

Trembly

How did Dr. Espinosa Rondain describe the behavior of patients with IAD?

Functional Neurological Symptom Disorder

What is the other name for Conversion Disorder?

Neurologic motor or sensory

What is the usual nature of the complaints in Conversion Disorder?

Blindness, dizziness, and seizures with no cause

What are three common complaints in conversion disorder?

Psychogenic seizures

What are convulsions called when they are not consistent with tonic clonic types in conversion disorder?

The patient is aware and has normal CT and EEG results

How do conversion seizures differ from typical seizures regarding awareness and diagnostic tests?

Sexual abuse or molestation

Conversion disorder is commonly associated with what type of past trauma?

Incompatibility

What must clinical findings provide evidence of between symptoms and recognized neurological conditions in conversion disorder?

Weakness, paralysis, abnormal movements, and gait abnormalities

Name four motor symptoms of conversion disorder.

Reduced skin sensations, vision, or hearing

Name three sensory symptoms of conversion disorder.

Subconscious refusal to acknowledge witnessing her daughter being molested

In the case of a blind patient what did the symptom indicate?

Sensation of a lump in the throat

What is a specific sensory symptom noted in conversion disorder?

Psychotropic medication

What treatment led to the gradual responsiveness of a mute conversion patient?

Two to three times more common in females

What is the gender prevalence of conversion disorder?

Younger children

Which age group has a better prognosis for conversion disorder?

MISSES GULPS

What is the mnemonic for Conversion Disorder?

Motor symptoms under voluntary control

In the MISSES GULPS mnemonic what does the M stand for?

Investigations do not reveal identifiable pathology

In the MISSES GULPS mnemonic what does the first I stand for?

Sensory symptoms under voluntary control

In the MISSES GULPS mnemonic what does the first S stand for?

Symptoms are not limited to pain or sexual function

In the MISSES GULPS mnemonic what does the second S stand for?

Experience is out of keeping with cultural norms

In the MISSES GULPS mnemonic what does the E stand for?

Social occupational or other abilities are impaired

In the MISSES GULPS mnemonic what does the third S stand for?

Gain considered as primary or secondary

In the MISSES GULPS mnemonic what does the G stand for?

Unintentional production

In the MISSES GULPS mnemonic what does the U stand for?

La belle indifference

In the MISSES GULPS mnemonic what does the L stand for?

Psychological factors associated with onset

In the MISSES GULPS mnemonic what does the P stand for?

Somatization disorder excluded

In the MISSES GULPS mnemonic what does the final S stand for?

La belle indifference

What is the term for a patient being unconcerned about their neurological deficits?

Anorexia Nervosa

Which disorder involves persistent intake restriction and intense fear of gaining weight?

Disturbance in self perceived weight or shape

What is the third diagnostic criterion for anorexia nervosa?

Weight in kilograms divided by height in meters squared

How is BMI calculated?

18.5 kg/m2

What is the WHO lower limit of normal body weight?

Mild anorexia

What does a BMI of greater than or equal to 17 indicate?

Moderate anorexia

What does a BMI of 16 to 16.99 indicate?

Severe anorexia

What does a BMI of 15 to 15.99 indicate?

Extreme anorexia

What does a BMI of less than or equal to 15 indicate?

Amenorrhea, hypotension, dehydration, and low sodium or potassium

Name four physical signs of anorexia nervosa.

Over controlling parents

What is a common psychodynamic factor behind patients with anorexia?

Food they put into their mouth

What is often the only source of control for an adolescent with over controlling parents?

Increased physical activity

AN patients often engage in what to lose more weight?

Laxatives or appetite suppressants

What medications might AN patients misuse?

0.4 percent

What is the 12 month prevalence of AN among young females?

Adolescence and early adulthood

When does AN typically begin?

Within 5 years of presentation

How soon does improvement usually occur in AN?

Leukopenia and anemia

What hematologic conditions result from poor nutrition in AN?

Elevated BUN level and hepatic enzymes

Which markers are elevated in blood tests for AN?

Low thyroid hormone and low estrogen or testosterone

What endocrine changes are seen in AN?

Sinus bradycardia and prolongation of the QT interval

What are the ECG findings for AN?

Low bone mineral density

What skeletal finding increases fracture risk in AN?

Amenorrhea, constipation, cold intolerance, and lethargy

List four physical signs of AN.

Fine downy body hair

What type of hair appears on the body of an AN patient?

12 per 100000 per year

What is the suicide risk rate for AN?

Developed countries

In what type of countries is AN more common?

15 times more common in females

What is the gender ratio for AN prevalence?

Regression to a child like state

AN fosters a psychological state where there are fewer demands and expectations called what?

Hospitalization

What is necessary for AN to prevent death from dehydration or cardiac arrhythmias?

Antidepressants, neuroleptics, and cyproheptadine

What three types of drugs are used to treat AN?

Group setting

Where should meals occur for AN patients to inhibit secretive behaviors?