Somatoform And Factitious Disorders

2,557 views

Published on

Published in: Health & Medicine
0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,557
On SlideShare
0
From Embeds
0
Number of Embeds
69
Actions
Shares
0
Downloads
168
Comments
0
Likes
3
Embeds 0
No embeds

No notes for slide

Somatoform And Factitious Disorders

  1. 1. Somatoform disorders Somatization and Conversion Pain and Hypochondriasis Body Dysmorphic Disorder
  2. 2. Somatoform symptoms <ul><li>Symptoms suggest a physical disorder </li></ul><ul><li>Symptoms cannot adequately be explained physiologically </li></ul><ul><li>Symptoms are often (but not always) described in dramatic ways </li></ul><ul><li>Other disorders, such as anxiety disorders, mood disorders, and personality disorders, often co-exist </li></ul>
  3. 3. Somatization Disorder (Briquet’s syndrome) <ul><li>Many physical complaints </li></ul><ul><li>Beginning before age 30 </li></ul><ul><li>Must include </li></ul><ul><ul><li>Four different pains </li></ul></ul><ul><ul><li>Two gastrointestinal symptoms </li></ul></ul><ul><ul><li>One sexual symptom </li></ul></ul><ul><ul><li>One pseudoneurological symptom </li></ul></ul><ul><li>Symptoms are unfounded or exaggerated </li></ul>
  4. 4. Conversion Disorder <ul><li>Physical symptoms suggesting neurological problems </li></ul><ul><ul><li>Sensory impairment: Any modality </li></ul></ul><ul><ul><li>Paresthesias and paralysis (demonstrate) </li></ul></ul><ul><li>Sudden onset, sudden termination, sudden reappearance </li></ul><ul><li>Mostly women; men in combat </li></ul><ul><li>Often misdiagnosed: Overpathologized </li></ul><ul><li>La belle indifference: 1/3 of cases </li></ul>
  5. 5. Pain Disorder <ul><li>Main symptom is pain </li></ul><ul><li>May be exacerbated by psychosocial factors </li></ul><ul><li>May be maintained by gain: </li></ul><ul><ul><li>Primary gain </li></ul></ul><ul><ul><li>Secondary gain </li></ul></ul>
  6. 6. Hypochondriasis <ul><li>No physical symptoms are necessary </li></ul><ul><li>Preoccupied with the possibility that normal sensations are symptoms of serious disease </li></ul><ul><li>Frequent visits to physicians </li></ul><ul><li>Persists despite medical reassurance </li></ul><ul><li>Over-report bodily sensations </li></ul>
  7. 7. Body Dysmorphic Disorder <ul><li>Excessive concern with real or imagined defects in appearance, especially facial marks or features. </li></ul><ul><li>Frequent visits to plastic surgeons </li></ul><ul><li>Culturally-influenced, but not culture-bound </li></ul><ul><li>May be a symptom of more pervasive disorders: Obsessive-compulsive or delusional disorder, for example. </li></ul>
  8. 8. Do advertisements affect BDD? “ Your nose is central to the way you feel about your appearance and the way other people first perceive you. “ If you are in the slightest way unhappy about it, and feel it detracts from your looks, you will probably always be unhappy about it.”
  9. 9. More somatoform-like disorders <ul><li>Malingering </li></ul><ul><li>Factitious disorder </li></ul><ul><ul><li>Personal </li></ul></ul><ul><ul><li>By proxy </li></ul></ul><ul><li>Undifferentiated Somatoform Disorder </li></ul><ul><li>Somatoform Disorder NOS </li></ul><ul><ul><li>Pseudocyesis (no everted umbilicus) </li></ul></ul><ul><ul><li>Hypochondriacal symptoms < 6 months </li></ul></ul>
  10. 10. Etiology of somatoform disorders <ul><li>Psychoanalytic theory </li></ul><ul><ul><li>Controlling repressed sexual urges </li></ul></ul><ul><ul><ul><li>Displaced anxiety or secondary gain </li></ul></ul></ul><ul><ul><li>Sackheim: Deny knowledge but use information </li></ul></ul><ul><li>Behavior theory </li></ul><ul><ul><li>Malingering </li></ul></ul><ul><ul><li>Social learning and reinforcement </li></ul></ul><ul><ul><li>Secondary gain </li></ul></ul>
  11. 11. DISSOCIATIVE DISORDERS
  12. 12. Dissociative Disorders <ul><li>Disruption in sense of coherent and stable personality identity </li></ul>
  13. 13. Dissociative Amnesia and Fugue <ul><li>Loss of memory for important personal information </li></ul><ul><li>Fugue = amnesia + flight </li></ul>
  14. 14. Dissociative Identity Disorder (Multiple Personality) <ul><li>Two or more distinct identities that control behavior </li></ul><ul><li>Typical alter personalities = child, protector, persecutor </li></ul><ul><li>90% female </li></ul><ul><li>>80% severely abused in childhood </li></ul>
  15. 15. Critics of Dissociative Identity Disorder <ul><li>Do clinicians elicit disorder? </li></ul><ul><li>Use in insanity defense cases </li></ul><ul><li>Can induce in normal person with hypnosis </li></ul>
  16. 16. Treatment of Dissociative Identity Disorder <ul><li>Confront trauma </li></ul><ul><li>Develop coping skills </li></ul><ul><li>Integrate personalities </li></ul>

×