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Somatization (Conversion Disorder (A. One of more symptoms of altered…
Somatization
Conversion Disorder
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sometimes after a stressor but not always; weakness, non-epileptic seizures, paralysis, dysarthria; dramatic and abrupt onset; short duration; women > men; abuse hx common
Ddx: rule out neuro disease, somatic symptom disorder, factitious disorder, malingering
Hoover sign: raise unaffected leg, involuntary contraction on the other side
comorbid: anxiety, depression, personality, somatic s/s disorder, neuro conditions
tx: therapy to help address underlying emotions, meds for comorbid anxiety and depression, physical tx
Illness Anxiety Disorder
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B. Somatic s/s NOT present or mild in intensity; preoccupation is clearly excessive and disproportionate
Distress comes from not the physical complaint but the meaning, significance, cause of the complaint
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treatment: CBT (alternative interpretations of bodily symptoms), SSRIs may help some
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Somatic symptom disorder
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B. Excessive thoughts/feelings/behaviors related to somatic s/s (high level of anxiety, excessive time and energy devoted to them)
C. >6 mos of s/s; more common in females, before age 30
Ddx: SUD, factitious, GED, depression, illness anxiety disorder, conversion disorder, delusional disorder
Tx: management not cure, regularly scheduled follow-up (not symptom driven), minimize polypharmacy
dr-pt relationship: countertransference, transference, limit setting (appts, test ordering)
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