Nura 201 - Somatoform, Factitious, And Dissociative D/o

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Somatoform D/O (Define)

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Group of disorders that convert anxiety into physical sx for which there is no identifiable physical diagnosis

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Signs of Somatoform D/O

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Physical symptoms suggest a physical disorder
Diagnostic tests are negative for physical illness
Symptoms are linked to psychobiological factors

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Malingering

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Intentionally producing symptoms to achieve an environmental goal

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Factitious Disorder

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Fabrication of symptoms or self-inflicted injury to assume the sick role

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Psychosomatic Illness

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A general medical condition affected by stress or psychological factors

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Biological Etiology of Somatoform D/O

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Changes in structure and function of the brain resulting from prolonged stress or trauma

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Behavioral Etiology of Somatoform D/O

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-Learned use of somatic d/o to communicate helplessness and manipulate others.
-Pt is unable to describe feelings in words & uses somatic d/o as a substitute expression of feelings

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Cognitive Etiology of Somatoform D/O

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Misinterpretation of bodily functions and sensations.

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Somatoform Disorders (Name Them)

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Somatization disorder, Hypochondriasis, Pain disorder,
Body dysmorphic disorder, Conversion disorder

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Signs of Somatization D/O

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Early onset and chronic course of SX without development of physical signs or structural abnormalities. Labs are negative. Complaints usually involve multiple organ systems.

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Signs of Hypochondriasis

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Fear r/t misinterpretation of physical sensations
despite medical evaluation and reassurance.
Clinically significant distress & impairment of function for 6 mos or longer.
Signs not caused by other d/o

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Signs of Pain Disorder

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Pain in one or more site leading to impairment. Psychological factors play role in onset, severity, exacerbation or maintenance of pain
The experience of pain is not a result of mood, anxiety or psychotic d/o

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Signs of Body Dysmorphic Disorder

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Preoccupation with an imagined or perceived defective body part.
Impaired social, academic, or occupational functioning
Major depression, anxiety, OCD common

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Signs of Conversion Disorder

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Presence of deficits in voluntary motor or sensory functions.
Symptom is not voluntarily produced.
Psychological factors r/t onset or exacerbation of sx.

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La Belle Indifference in Conversion Disorder

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A relative lack of concern about the nature or implications of the symptoms

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Signs of Factitious D/O

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Intentionally production of sx of psychological or physical d/o to assume the sick role.
Also avoidance of legal problems or responsibility, economic reasons as a secondary gain.

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Facititious D/O vs Malingering

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Secondary gains with Malingering, but no psychological need to assume sick role.

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Munchausen vs Factitious D/O

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Munchausen is deception to gain sympathy

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Signs of Depersonalization D/O

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Alteration in perception of self, reality testing remains intact.

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Signs of Dissociative Amnesia

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Inability to recall important personal information that is usually of traumatic or stressful nature. Can be generalized, local or selective.

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Signs of Dissociative Fugue

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Sudden unexpected travel away from the customary locale, Inability to recall one's identity and some or all of the past. Tend to live simple, quiet lives after fugue state ends, becomes amnesic for time spent in fugue state.

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Signs of Dissociative Identity Disorder

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Presence of two or more distinct personality states.
Primary personality usually not aware of alters, alters take control of behavior. Alters often aware of other alters. Each alter thinks and behaves as a separate individual.