Rob_s undergrad.Tx somatization.2009

Rob_s undergrad.Tx somatization.2009 - CBT for Somatization...

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CBT for Somatization Lesley A. Allen, Ph.D. Department of Psychiatry UMDNJ-RWJMS
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UPS are Widespread Community studies 80% adults had > 1 UPS in a week (Pennebaker, 1982) Adults developed a new symptom every 5-7 days (Demers et al., 1980) Primary care studies 25-30% of primary care visits for UPS The most common diagnosis is “nonsickness”
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Somatoform Disorders The presence of physical symptoms that suggest a general medical condition The physical symptoms are not fully explained by   a medical condition  the direct effects of a drug a psychiatric disorder
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DSM-IV Somatoform  Disorders Somatization Disorder Undifferentiated Somatoform Disorder Hypochondriasis Pain Disorder Conversion Disorder Body Dysmorphic Disorder
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Somatization Disorder Α History of physical symptoms before age 30,  resulting in medical treatment and/or disability Β Physical symptoms involving multiple systems  4 pain 2 gastrointestinal 1 sexual  1 pseudoneurological C Symptoms remain medically unexplained or are  grossly in excess of medical expectations
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Characteristics of Patients with Somatization Disorder Overutilize health care  (Smith et al., 1986)  expenses are 9 X that of ave. American Comorbid psychopathology  (Swartz, 1986)  78% had another lifetime Axis I disorder  (esp., anxiety and affective disorders)
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Characteristics of Patients with Somatization Disorder High rates of disability 44% on work disability  (Swartz et al., 1986) 2-7 days in bed/month  (Smith et al., 1986)
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Somatization Disorder: Epidemiology Low prevalence: < 1% in the community 2 - 5 % in primary care More common in women than men More common in certain cultures than others High prevalence in Latino cultures Types of symptoms vary across cultures
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Rob_s undergrad.Tx somatization.2009 - CBT for Somatization...

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