Individuals with illness anxiety disorder Quizlet

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    Terms in this set (35)

    Somatic Symptom Disorder

    "hypochondriasis"

    Characterized by 6 or more months of preoccupation with fears of having, or the idea that one has, a serious disease-causes distress

    Etiology of Somatic Symptom Disorder

    Psychosocial factors
    Biological factors

    Epidemiology
    of Somatic Symptom Disorder

    Prevalence is around 2-11% in the general population

    Most commonly appears age 20-30

    More common in females

    Risk Factors for Somatic Symptom Disorder

    Female gender, hx of physical/sexual abuse

    Associated with depression, anxiety

    Characteristics of Somatic Symptom Disoder

    Many somatic complaints with long & complicated medical histories-vague, imprecise, inconsistent, disorganized

    patients always believe they are sick and don't believe the negative evaluations

    The symptoms are dramatic and emotional-anxiety and depression prevalent

    early onset & chronic course-no physical signs or abnormalities

    Differential Diagnosis for Somatic Symptom Disorder

    1. Other medical conditions
    2. panic disorder
    3. generalized anxiety disorder
    4. depressive disorders
    5. illness anxiety disorder
    6. conversion disorder
    7. delusional disorder
    8. body dysmorphic disorder
    9. OCD

    Treatment of Somatic Symptom Disorder

    -Single identified provider as primary caretaker
    -regular scheduled visits
    -Visits should be brief
    -Labs and diagnostic procedures should be avoided unless objective findings warrant them
    -Psychotherapy
    -Pharmacological treatment aimed at treating depression or anxiety

    Prognosis of Somatic Symptom Disorder

    Chronic and relapsing disorder, rarely remits completely

    Estimated that 33-50% eventually improve significantly

    Good prognosis of Somatic Symptom disorder associated with what?

    High socioeconomic status

    Absence of personality disorder

    Treatment responsive anxiety/depression

    Conversion Disorder

    Functional Neurological Symptom Disorder (DSM-5)
    Characterized by neurologic symptoms that are inconsistent with neurologic disease, causing distress and/or psychosocial impairments

    Etiology of conversion disorder

    Psychoanalytic factors

    Due to the repression of unconscious intrapsychic conflict

    Conversion of anxiety into a physical symptom

    Learning theory
    Classically conditioned learned behavior

    Biological factors of conversion disorder

    Hypometabolism of the dominant hemisphere of the brain

    Hypermetabolism of the nondominant hemisphere

    Risk Factors for conversion disorder

    Psychosocial stressors

    Possible association with hx childhood sexual abuse

    More common in patients with depressive disorders, anxiety and panic disorders

    More common with borderline, histrionic and narcissistic personality disorders

    Epidemiology of conversion disorder

    Found in 5% of individuals referred to neurology clinics

    Women are 2-10x more effected than men

    Onset rare before age 10 or after age 35

    Sings and Symptoms of conversion disorder

    Most common: weakness or paralysis, sensory symptoms, visual symptoms

    Nonepileptic seizures

    Movement disorders

    Speech disturbances

    Globus sensation (lump in your throat)

    Cognitive symptoms

    Differential Diagnosis of conversion disorder

    Often difficult to completely rule out a medical disorder

    Neurological disorders brain tumors
    basal ganglia disease somatic symptom disorder factitious disorder and malingering
    dissociative disorders
    body dysmorphic disorder depressive disorders
    panic disorder

    Treatment of conversion disorder

    First-line tx: education about the illness

    Psychotherapy - CBT

    Consider referral to Psychiatry

    Alternatives - pharmacotherapy (depression or anxiety), hypnosis

    (Telling patients their symptoms are imaginary often makes them worse)

    Prognosis of conversion disorder

    Prognosis is generally poor
    Symptoms persist, or worsen, in 40-66%

    Factors associated with a positive outcome for conversion disorder

    Early diagnosis

    Good response to initial treatment

    Comorbid anxiety or depression

    Good therapeutic alliance with provider

    Illness Anxiety Disorder

    Previously called hypochondriasis (DSM IV)

    What is illness anxiety disorder characterized by

    Characterized by a general and nondelusional preoccupation with fears of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily symptoms

    (minimal to no symptoms, somatic symptom disorder has a ton of symptoms)

    Etiology of illness anxiety disorder

    Unclear genetic factors

    Possible neurochemical factors

    Risk Factors of illness anxiety disorder

    80% of patients have co-exiting depressive or anxiety disorders

    Occurs more frequently in less educated

    Characteristics of illness anxiety disorder

    Patient believe that they have a serious disease that has not been detected

    Persist despite negative lab results & reassurance

    Concern about the illness is central feature of persons life& consult multiple physicians

    Transient episodes can occur after major stresses

    Differential diagnosis for illness anxiety disorder

    Must rule out non-psychiatric medical conditions
    Adjustment disorders, somatic symptom disorder, anxiety disorders, OCD, major depressive disorder

    Treatment for illness anxiety disorder

    first-line tx is psychotherapy

    Group therapy often is beneficial

    Pharmacotherapy can be considered (only SSRIs have been studied)

    Most will be resistant to having the psychotherapy

    Body dysmorphic disorder

    Characterized by the preoccupation with an imagined defect in appearance that causes clinically significant distress or impairment in important areas of functioning

    Etiology of body dysmorphic disorder

    Cause is unknown

    Pathophysiology of the disorder may involve serotonin and may be related to other mental disorders

    Risk factors for body dd

    High comorbidity with depressive disorders, anxiety disorder
    Female
    Unmarried

    Epidemiology of Body dd

    occurs in 2.4% of the general population

    Most common age of onset is between is 15-30 years

    Affects women slightly more than men

    Signs/symptoms of body dd

    More common concerns involve facial flaws (nose)

    Other body parts of concern are hair, skin, eyes

    Many have ideas/delusions of reference, believing that other people take special notice of them or mock them because of how they look

    May be associated with anxiety or depressive symptoms

    Signs and symptoms of body dd in men

    Desire to bulk up and develop a large muscle mass

    Treatment of Body dd

    Treatment with surgery, dermatological treatment, dental, or other medical procedures is unsuccessful

    Antidepressants can reduce symptoms

    Plastic surgery in body dd

    higher prevalence of BDD in men seeking penile enlargement and women seeking cosmetic surgery of the labia or the lips

    Prognosis of body dd

    not great, continuous, chronic issue, not likely to have any prolonged symptoms free periods, increased risk of suicide

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