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Somatic and Somatoform
These disorders are characterised
by multiple somatic complaints or physical symptoms such as pain, nausea, depression,
dizziness. Somatoform disorders are physical symptoms which present as part of a
general medical condition.
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No general medical condition, other mental
disorder, or substance misuse is adequately diagnosed.
The complaints are serious enough to cause
significant emotional distress and impairment of social and/or occupational
functioning.
Symptoms see below under each disorder
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When to assess...
- Many unexplained medical illnesses
- Health and Image preoccupation
- Repeated and disproportionate seeking of medical assessment
and treatment often to multiple doctors
- Psychiatric history of neurotic or stress related disorders
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Diagnostic interview
question tips...
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Hypochondriacal disorder
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Persistent preoccupation with
the possibility of having serious and progressive physical disorder/s
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Persistent preoccupation with
somatic complaints or a persistent preoccupation with their physical appearance
(Dysmorphophobia)
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Normal or commonplace sensations
and appearances interpreted as abnormal and distressing
'Do you
often think that you might have health problem? Why?'
'Do you often worry about how your body feels and looks?'
'Are you often worried that part of you doesn’t look normal?'
'Have you ever felt symptoms that you knew meant something was seriously wrong?'
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Somatization disorders
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Multiple, recurrent and frequently
changing medically unexplained symptoms
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Symptoms may be referred to
any part or system of the body
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Tend to be associated with
disruption of social, interpersonal, and family behaviour
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At least two years' duration
Somatoform autonomic dysfunction
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Symptoms of a system or organ
that is largely or completely under autonomic innervation and control i.e. the
cardiovascular, gastrointestinal, respiratory and urogenital systems
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Complaints based upon objective
signs of autonomic arousal (e.g. palpitations, sweating and tremor) or subjective
complaints of a non-specific or changing nature (e.g. fleeting aches and pains)
Persistent somatoform pain
disorder
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Complaint is of persistent,
severe, and distressing pain...
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...cannot be explained fully
by a physiological process or a physical disorder
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Occurs in association with
emotional conflict or psychosocial problems
'Have
you had a lot of unexplained medical illnesses?'
'Have you had any of the flowing which has gone on for several years without
explanation…
… Pains anywhere in the body?
… Nausea, vomiting, bloating, gas, diarrhoea?
… Problems with your sex life?
… Irregular or abnormal periods?
… Problems with your vision, hearing, balance?
… Headaches, blackouts, fits?'
Generically associated Emotional / Psychological
'How have you been
feeling in yourself recently?'
'Are you often preoccupied by theses worries?'
'How much of an impact does it have on you?'
'How has it impacted on your life?'-
'What do you think is the cause of these symptoms?''
'Have
you been depressed or gone through a long period of having low mood?' (Dysthymia
/ Depression)
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