Please enable JavaScript.
Coggle requires JavaScript to display documents.
Somatisation Disorders (incomplete) (Clinical Features (Non-specific,…
Somatisation Disorders (incomplete)
Definition
Multiple
Full blown disorder = Briket's disorder
Characterised by repeated presentation of medically unexplained symptoms affecting multiple organ systems (at least 2) - presenting before the age of 40
Usually chronic in adults
Children: involves 1 or a few organ systems for shorter period
Clinical Features
Non-specific, atypical symptoms
Discrepancy between subjective and objective findings
Symptoms are usually concentrated on one system at a time but may move to another
Multiple, atypical and inconsistent medically unexplained symptoms in patient under 40
Aetiology
Observable clinical association with childhood illnesses in the patient
History of parental anxiety towards illness
Increased frequency of somatisation disorder in 1st degree relatives
Association with sexual abuse in childhood
Epidemiology
Lifetime prevalence of 0.2%
F > M
Diagnosis
ICD-10 F.45
A) History of at least 2 years complaints of multiple and variable physical symptoms that cant be explained by any detectable physical disorder
B) Preoccupation with the symptoms causes epristent distress and leads to seeking >6 consultations/investigations from doctors
C) Peristent refusal to accept medical advice that there is no apparent physical cause for the physical symptoms
D) Total of >6 symptoms from multiple body systems with symptoms occuring in at least 2 seperate groups
Management
Initial Management
Communicate the diagnosis
Acknowledge severity and experience of distress
Emphasise negative investigations
Assess and treat psychiatric comorbidity as necessary
reduce and stop unnecessary drugs
Ongoing Management
Psychotherapy
Use of eclectic psychotherapy gives insight into psychological disorders