9- Somatoform Disorders (1).pdf - Somatoform Disorders B Y...

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Somatoform Disorders BY: DUAA AL-DAHNEEM RANEEM ASHOUR
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Objectives Somatoform Disorders - Somatization Disorder - Conversion Disorder - Hypochondriasis - Body Dysmorphic Disorder - Pain Disorder Factitious Disorder Malingering Disorder
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Somatoform Disorders A group of disorders characterized by the presentation of physical symptoms with no underlying organic cause or medical explanation, which causes significant distress or impairment in social, occupational or other area of functioning.
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Somatoform Disorders These patients are not consciously feigning symptoms. They are truly convinced they have a medical problem. Classic somatoform disorder patient: female, young, low socioeconomic status.
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Somatoform Disorders The symptoms expressed in these disorders result in: Primary gain: symptoms as an unconscious defense against internal conflicts Secondary gain: symptoms that provide unconscious external benefits
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Somatoform Disorders Types: - Somatization Disorder - Conversion Disorder - Hypochondriasis - Body Dysmorphic Disorder - Pain Disorder - Undifferentiated Somatoform Disorder - Somatoform Disorder Not Otherwise Specified
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Somatization Disorder
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Case Ms. X is a 31-year-old woman who was referred to a psychiatrist after undergoing multiple exploratory surgeries for abdominal pain and gynecologic concerns with no findings. She has had extensive medical problems dating back to adolescence. The obstetrician is her fourth provider.
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..Case She states that her problems worsened in college. She reports that due to her health problem and lack of energy, it took her 5.5 years to graduate. Additionally, it was hard for her to find a partner who would tolerate her frequent illnesses. She is concerned she might lose her job due to the number of days she has missed from work due to abdominal, fatigue and weakness.
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..Case Review of symptoms: GI complaints: diarrhea, vomiting, bloating Neurological symptoms: double vision, ringing in ear, weakness Reproductive system symptoms: irregular menses, urinary difficulties Pain complaints: abdominal pain, joint and muscle pain, headaches.
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Somatization Disorder 5-10% of patients presenting in primary care Present with multiple, often nonspecific, physical symptoms involving many organ systems Patients with somatization disorder typically express lots of concern over their condition [ So Ma ny physical complaints]
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Somatization Disorder DSM-IV Criteria: Onset before age 30 At least 4 pain symptoms At least 2 GI symptoms At least 1 sexual or reproductive symptom At least 1 pseudoneurological symptom (not limited to pain) Cannot be explained by general condition Symptoms must not be intentionally produced
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Somatization Disorder Epidemiology Females > males by 5-20x Lifetime prevalence: 0.1-0.5% Half have comorbid medical disorder 30% concordance in identical twins Low SES (reports of sexual or physical abuse)
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Somatization Disorder Treatment and Prognosis Course is chronic and debilitating
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