Somatoform disorders T. Omidvar,MD. The key characteristic of somatoform disorders: preoccupation...
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Transcript of Somatoform disorders T. Omidvar,MD. The key characteristic of somatoform disorders: preoccupation...
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Somatoform disorders
T. Omidvar,MD
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• The key characteristic of somatoform disorders:
• preoccupation with physical symptoms
• without explanation of any medical conditions
• leading to significant stress
• not intentionally produced
Definition
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• Somatization disorder
• Conversion disorder
• Pain disorder
• Hypochondriasis
• Body dysmorphic disorder
• Somatoform disorder nos
• Undifferentiated somatoform disorder
Somatoform disorders in DSMIV
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Epidemiology
• very common in all countries and cultures
• physical symptom the most common presentation
• idiopathic physical symptoms: no organic cause
• finding 20%-80%
• co-occuring with psychiatric disorders
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Etiology
• Using a biopsychosocial model
• biological vulnerability
• early traumatic experience
• learning factors
• Leading to focus on the somatic and difficulty
expressing emotions (alexythymia)
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Course and prognosis
• Chronic course associating with personality and
cognitive style
• Inconsistency in symptom presentation
• With these symptoms psychiatric disorders becoming
more severe
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Treatment
• Establishing an alliance
• Taking the history
• Reassurance
• Physical versus psychological focus
• General therapeutic approach
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SOMATIZATION DISORDER
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Definition:
• a polysymptomatic syndrome
• physical symptoms coming from several organs
• causing significant stress
• severe reluctancy to accept psychological etiology
Somatization disorder
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DSMIV criteria
four pain sites or functions (back, chest,..)
• two non pain GI symptoms(nausea, bloating)
• one non pain sexual symptom(loss of libido)
• one pseudoneurological symptom (aphonia, ..)
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Epidemiology
• More common among females
• Individuals from lower socioeconomic states
• Having comorbidity with depression and anxiety
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• Some biological factors :
– violence in biological fathers of the woman with
somatization
Etiology
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Treatment
• General considerations
• Pharmacotherapy
• Reassurance and supportive therapy
• psychotherapy
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PAIN DISORDER
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Pain disorder
• Pain : one of the most complaints in medical practice
• Associating with psychological stress
• Deciding that the pain is psychogenic
can be difficult
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Definition
• Complaints of severe, persistent pain in one or more
areas
• Warrant clinical attention
• Cause significant impairment in function
• Relatedness of severity , exacerbation and
maintenance of symptoms with psychological factors
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Treatment
• Approaching the patient
• Pharmacological management
• Psychotherapy
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Thanks for your attention
Any Question?