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Lecture 6

Lecture 6 - Somatoform Disorders

Course Code
Konstantine Zakzanis

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Heterogeinity – no two patients are alike; Inter rater reliability is poor ; Cultural factors play
of moderating role; Somatofor m can be offensive to patients
Somatofor m Disorders
Common disorder among groups of disorders
Pains have to cause distress or impair or disablize ADL
DSM has 3 subsets but at the middle is ever diagnosed both psychological and general
medical conditions
Because pain is a subjective experience – dont actually have a test to be objective never
know if physical or psychological phenomenon
The case of The boards - woman – car accident – sharp pains - distress – mar r iage
dysfunction – dissapointed – attack her husband – arguing in car – bec. Of pains no
sexual contact (both psychological factors and maybe medical conditions rises)
Reinforcement of being disabled
Co morbid e.g. social phobia and depression sad about your condition – delusional disorder
Diff icult to treat – aesthetic repair
Distress and disability to be diagnosed with it
Ir regular heart beat over interpret and catastrophiz e – negative life events and thought CBT – but
disorder is quite chronic
Difficult to differentiate from somatization and hypondhr iac
Hypochondriac - have shifting complains and have a belief of specific disorder
Somatization – characterized by consistent complaints but typically s ymptoms complaints
Women begins in early adulthood and run in families 20 % chance
Ideological factors – modeling - complaining parents –believe that its ok to complain
Comorbid with anxitey and depression and substance abuse dependence in pain relievers
And 1 personality disorder – histrionic and with conversion disorder
Conversion, Malingering and Factitious Disorders
Paralysis, seizures, tingling blindess aphomia – loss of voice, anosmia- loss of smell, complete or
partial , symptoms appe ar suddenly as result of disorder but somatization gradually s ymptoms
Malingering and Fictitious Disorders
Malingering – when person is consciously faming impairment in the context of external
incentives – e.g. disability insurance check, getting out of military or exams
Factitious D – consciously produces impairment but no external incentives why dont know but
pt. wants to adopt sick role
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