Somatoform, Factitious, and Dissociative Disorders

1. Somatoform, Factitious, and Dissociative Disorders

2. Somatoform Disorders • Convert anxiety into physical symptoms • Physical symptoms without organic disease • Reflect complex interactions between mind and body • May cause serious impairments in social and occupational functioning

3. Etiology of Somatoform Disorders • Biologic • Behavioral • Cognitive

4. Types of Somatoform Disorders • Somatization disorder • Pain disorder • Conversion disorder • Hypochondriasis • Body dysmorphic disorder

5. Somatization Disorder • Formerly called hysteria • Frequently seeking and obtaining medical treatment for multiple, clinically significant somatic complaints • Diagnosis requires: • Involvement of multiple organ systems • Early onset and chronic course without development of physical signs or structural abnormalities • No clinical laboratory abnormalities commonly associated with general medical conditions

6. Pain Disorder • Pain in one or more anatomic sites with significant impairment in one or more areas of functioning • Psychological factors may play an important role in the onset, severity, exacerbation, or maintenance of the pain

7. Conversion Disorder • Exhibits one or more symptoms that affect voluntary motor or sensory function • Causes significant distress in social, occupational, or other areas of functioning • Common forms include blindness, paralysis, seizures, deafness, or abnormal motor movements • http://youtu.be/LRzytAhu0hg

8. Hypochondriasis • Fears having (or the idea of having) a serious medical problem • Misinterpretation of symptoms persist despite medical evaluation • Preoccupation with illness • Causes significant distress in everyday function • http://youtu.be/V-Jr7ewKHY4

9. Body Dysmorphic Disorder • Preoccupation with an imagined defect in appearance • Slight anomaly has an excessive response • Causes significant distress in everyday functioning

10. Factitious Disorder • Intentionally produces physical or psychological signs to assume the sick role • Behavior satisfies need for secondary gains • http://youtu.be/9TExiUUEFqI

11. Types of Dissociative Disorders • Dissociative amnesia • One or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature • Dissociative fugue • Sudden, unexpected travel away from home or one’s customary place of work, with an inability to recall one’s past

12. Types of Dissociative Disorders, cont’d. • Dissociative identity disorder • Demonstrates two or more distinct identities or personality states • At least two of these personality states recurrently take control of the person’s behavior • Depersonalization disorder • Persistent or recurrent episodes of feelings of detachment or estrangement from one’s self

13. Treatment Modalities • Psychotherapy • Behavioral therapy • Cognitive behavioral therapy • Pharmacotherapy • Nursing Interventions: • Recognize that these disorders are chronic and enduring. • Monitors one’s own anxiety • Limit caffeine, nicotine, and other CNS stimulates • Suicide precautions