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Somatisation disorder (Birquet's syndrome) (Diagnosis (History (PPH …
Somatisation disorder
(Birquet's syndrome)
Pathophysiology
Precipitating
Illness (physical, psychiatric)
Trauma
Changing social circumstances)
Perpetuating
Diet, exercise, alcohol, drugs
Psychiatric illness
Social situation
Prediposing
Genetics, personality
Learnt illness beliefs
Childhood illness
Physical illneess
Clinical
presentation
Multiple vague symptoms
(skin, GIT, menstrual, sexual)
Diagnosis
Examination
All nil; if abdo pain, then further from
the umbilicus then more likely to be organic
Investigations
All nil
History
PPH
Psychaitric conditions
Previous admissions and treatment
DH
Meds, allergies
PMH
Chronic medical conditions
FH
Psychiatric illness
PC/HPC
Vague symptoms usually
affecting skin, GIT, menstrual
SH
Social support, living arrangements,
occupation, alcohol, smoking, drugs
Diagnostic criteria
(ICD-10)
Symptoms affecting any part of body
Investigtions show inexplicable by
medical condition (medically unexplained symptoms)
Psychical symptoms starting <30y
Management
Conservative
Information, advice, support
Identify underlying psychiatric disease
Relaxation techniques
Refer to CAMHS if unclear
Prognosis
High comorbidity with other
mental health conditions
Often prolonged (>5y)
Complications
Iatrogenic harm
Reduced QoL
Definition
Psychiatric disorder presenting
as physical symptoms
Epidemiology
Very common
Adults, adolescents and children
Starts <30y