Somatoform Factitious Disorders .

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Somatoform Disorders. Key Feature: TypesSomatization DisorderConversion DisorderHypochondriasisSomatoform Pain DisorderBody Dysmorphic SyndromeUndifferentiated Somatoform Disorder. Fast however superfluous. Body Dysmorphic DisorderPain Disorder. Somatization Disorder: Diagnostic Features. Key component: Multiple, unexplained symptomsCriteria4 torment 2 GI 1 sexual/reproductive1 pseudoneurologicalIf withi
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Somatoform & Factitious Disorders (Thanks to: Drew Bradlyn, Ph.D.)

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Somatoform Disorders Key Feature: Types Somatization Disorder Conversion Disorder Hypochondriasis Somatoform Pain Disorder Body Dysmorphic Syndrome Undifferentiated Somatoform Disorder

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Quick however superfluous Body Dysmorphic Disorder Pain Disorder

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Somatization Disorder: Diagnostic Features Key element: Multiple, unexplained side effects Criteria 4 torment 2 GI 1 sexual/conceptive 1 pseudoneurological If inside a medicinal condition, XS sxs Lab anomalies truant Not purposefully pretended or delivered

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Somatization Disorder: Associated Features Colorful, overstated terms Inconsistent students of history Depressed disposition and nervousness indications Chronic, infrequently transmits totally Lifetime commonness: 0.2% - 2% F < 0.2% among men

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Hypochondriasis: Diagnostic Features Key component: fear/conviction - infection Criteria Unwarranted dread or thought holds on in spite of consolation Clinically critical misery Not limited to appearance Not of whimsical force

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Hypochondriasis: Associated Features Medical history regularly introduced in extraordinary detail Doctor-shopping basic Patient may trust s/he is not getting appropriate care Patient may get superficial PE; med condition might be missed Negative lab/physical exam comes about M = F Primary care predominance: 4 - 9% May turn into a total invalid

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Conversion Disorder: Diagnostic Features Key Feature: Criteria Symptoms are gone before by stressors Symptoms are not deliberately faked or created No neuro, therapeutic, substance mishandle or social clarification Must bring about checked trouble

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Conversion Disorder: Associated Features In 10 - half - >physical sickness F > M (shifts from 2:1 to 10:1) Symptoms don\'t acclimate… Prevalence ranges from 11/100,000 to 300/100,000 Outpatient emotional wellness: 1 - 3% "la looker aloofness" Histrionic Figure of personality

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More on Somatoform Hypochondriasis is most normal (M = F) Somatization issue lifetime chance for F <3% Conversion and somatoform torment d/o F > M, yet found in <1% of populace Higher frequency in restorative settings (?half) 10% of med-surg patients have no physical proof of malady Costs of assessing and treating = $30 billion in 1991

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Gains of ailment Social disengagement Amplification Symptoms utilized as correspondence Physiologic concomitants of psych d/o Cultural mentalities Religious variables Stigmatization of psych ailment Economic issues Symptomatic treatment Ford (1992) Factors that Facilitate Somatization

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Differential Things that effect: Concrete discoveries Perception of Illness Presentation of Illness

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"Solid" Diseases that don\'t take after the tenets

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Perception Psych ailments: Depression Anxiety Psychosis Other, more unusual stuff

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Presentation Malingering Factitious Disorder More typical things

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Factitious Disorder Key Feature: Sx\'s Intentionally created to accept wiped out part Types Factitious Disorder Factitious Disorder by Proxy

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Factitious Disorder: Associated Features M > F Hospital/human services laborers External motivations truant Distinguished from somatoform… Distinguished from malingering…

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Review Question 32 YO unmarried lady is told by her specialist that his is leaving on a get-away. after 1 week, the doc gets a crisis call, observes the patient detailing herself to be in the process of giving birth: with HIS kid. On examination, the patient shows up bloated and in trouble, however not really pregnant. What\'s going on!

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Review Question 42 YO man presents to a PMD saying that he trusts he has Lyme\'s sickness. His principle sx is unending and steady migraines. He clarifies that 2 courses of oral amoxicillin and ceftriaxone have not aided, and he is requesting oral anti-infection agents. The patient is steady: saying last specialist didn\'t realize what he was doing, and that his significant other is getting exceptionally baffled with him. History uncovers no hazard elements, exam is unremarkable, Lyme titer is negative. What is the in all probability determination? What\'s going on?

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Review Question A neurologist counsels you on a patient: he takes note of that he has analyzed MS in the this 35 YO lady, however is doubtful whether she truly has it. He says that her real side effect is an "odd walk" which doesn\'t comply with any stride disfigurement he has seen. On meeting, patient is charming. She knows about the strangeness of her walk, and the developing uncertainty among her specialists. She can\'t clarify her stride, just portraying a feeling of shortcoming. How might you approach this patient What might you request that analyze the case.

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