PSY 230 Lecture Notes - Lecture 12: Factitious Disorder, Somatization Disorder, Hypochondriasis
11 Oct 2018
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Department
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PSY 230
Lecture 12
Somatoform & Dissociative Disorders
● Somatoform Disorders
○ Soma - “Body”
■ Preoccupation with health and/or body appearance and functioning
■ No identifiable medical condition causing the physical complaints (BUT
PHYSICAL CAUSE IS NOT REQUIRED; THE PREOCCUPATION/WORRY/DISTRESS IS
CHARACTERISTIC)
■ Why is this a challenging population?
● Challenging patient population
○ Chronic, difficult to treat
○ High utilizers of the medical systems
● Risks
○ Repetitive, unnecessary diagnostic testing
○ Invasive medical/surgical workups
○ Medically induced (iatrogenic) illness
○ Types of DSM-IV Somatoform Disorders
■ Hypochondriasis (NO LONGER EXISTS)
■ Somatization disorder
■ Pain disorder
■ Body dysmorphic disorder (NOW ANOTHER CATEGORY)
■ Conversion disorder
■ Somatic Symptom Disorder
■ Illness Anxiety Disorder
■ Conversion Disorder (Functional Neurological Symptom Disorder)
■ Factitious Disorder
○ Somatic Symptom Disorder
■ New diagnosis
■ Includes “former somatization disorder” and “hypochondriasis”
■ Presence of symptom, medically explained or not
■ Health concerns as a central role in an individual’s life
■ (Different from OCD because OCD involves worry about a future incident but
SSD involves a current worry)
■ DSM Criteria
● 1 or more somatic symptoms that are distressing or result in significant
disruption of daily life
● Excessive thoughts, feelings, behaviors related to the somatic symptoms
as manifested by at least one of the following:
○ Thinking too much about one’s symptoms
○ High level of anxiety about health or symptoms
Document Summary
Preoccupation with health and/or body appearance and functioning. No identifiable medical condition causing the physical complaints (but. Physical cause is not required; the preoccupation/worry/distress is. Presence of symptom, medically explained or not. Health (cid:272)o(cid:374)(cid:272)er(cid:374)s as a (cid:272)e(cid:374)tral role i(cid:374) a(cid:374) i(cid:374)di(cid:448)idual"s life (different from ocd because ocd involves worry about a future incident but. 1 or more somatic symptoms that are distressing or result in significant disruption of daily life. Excessive thoughts, feelings, behaviors related to the somatic symptoms as manifested by at least one of the following: High level of anxiety about health or symptoms. Excessive time and energy devoted to these symptoms/health concerns. Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent for at least 6 months. Medical chart review shows prevalence in women as high as 2% Liberal criteria rates as high as 11. 6% 50% of patients presents in primary care with physical symptoms has no diagnosable disease.
