Behavioral Med Somatic Symptom and Related Disorders

Somatic Symptom and Related Disorders

A group of mental health conditions characterized by excessive focus on physical sxs (such as pain, fatigue, or GI distress) that cause significant distress or impairment

These sxs are real to the pt, but their severity or persistence cannot be fully explained by a medical condition

Somatic Symptom and Related Disorders has multiple organ systems involved

What is a main discriminating feature between Somatic Symptom and Related Disorders versus physical illness?

1) Somatic symptom d/o

2) Illness anxiety d/o

3) Conversion d/o

4) Factitious d/o

5) Psychological factors affecting other medical conditions

What are the 5 main classifications of Somatic Symptom and Related Disorders in DSM-5?

Somatic symptom d/o

Patients have real, distressing sxs but think they have some severe, yet undetected dz

family stress

What is the primary etiology of somatic symptom d/o?

≥1 sx

≥6 months

How many sxs and how many months to dx somatic symptom d/o?

Illness anxiety d/o

Patients have minimal or absent sxs but think they have some severe, undiscovered dz

1 month

How long must preoccupations be occurring to have illness anxiety d/o?

CBT

What is 1st line tx for illness anxiety d/o?

1° gain

the psychological relief or resolution of internal conflict achieved through the expression of physical symptoms

ex: A person experiencing intense anxiety about a stressful job may unconsciously develop physical symptoms (e.g., headaches) that prevent them from attending work, thereby reducing their stress.

mechanism: symptoms serve as a defense mechanism to protect the individual from psychological distress

2° gain

the external benefits or advantages gained from having physical sxs

ex: A person with chronic pain may receive increased attention, care, or financial benefits (e.g., disability compensation) that reinforce their symptoms.

mechanism: symptoms are maintained by the tangible rewards or social advantages they bring

functional neurological sxs disorder

conversion d/o is aka...

conversion d/o (functional neurological sxs d/o)

Mental health condition in which an individual experiences neurological sxs (e.g., paralysis, blindness, seizures, or numbness) that are inconsistent with or cannot be fully explained by medical or neurological conditions

< 6 months

An acute episode of functional neurological sxs (conversion) d/o is distinguished from persistent by how long?

motor: TICS, paralysis seizure d/o

sensory: blindness, deafness, and mutism

What motor and sensory s/sx are most common with conversion d/o?

females

What gender is conversion disorder more common in?

<50%

If conversion disorder is present for 6 months, the prognosis of resolution is _______.

this is related to conversion d/o and refers to a lack of concern or apparent indifference about the severity of sxs

grossly unconcerned attitude about what appears to be major impairment

"inappropriate cavalier attitude"

Background

Affect

Trouble

Handle

Empathy

What is BATHE'ing a patient with Somatic Symptom and Related Disorders?

factitious disorder

mental health condition where an individual intentionally produces or exaggerates physical or psychological symptoms in themselves, without obvious external incentives (such as financial gain or avoiding work). The primary motivation is to assume the "sick role" and gain attention, sympathy, or care, rather than for material benefits.

1) reduce r/o morbidity/mortality

2) address underlying emotional needs or psychiatric dx underlying factitious illness behavior

3) be mindful of legal and ethical issues

What are the 3 main goals of treating factitious disorder?

malingering

deliberate falsification of physical or psychological sxs

with the intention to achieve secondary gain (external)

Psychological Factors Affecting Other Medical Condition

physical disorders caused by or adversely affected by emotional or psychological factors

medical condition

What must be present to dx Psychological Factors Affecting Other Medical Conditions?

the presence of:

- 1 or more sx

- clinically significant

- psychological or behavioral factors adversely affect a medical condition

- increase r/o suffering, death, disability

What is the essential feature of psychological factors affecting other medical conditions?

1) alarm rxn

2) resistance/adaptation

3) exhaustion

What are the 3 stages of the general adaptation syndrome for stress?