DISORDERS OF BODILY PREOCCUPATION Chapter 6 DISORDERS OF BODILY PREOCCUPATION

DSM-IV DISORDERS PAIN DISORDER SOMATOFORM DISORDER FACTITIOUS DISORDER AND MALINGERING

SOMATOFORM DISORDERS Pain disorder – Psychological factors play a large role in pain Somatization disorder – Multiple complaints over a period of years Conversion disorder – Unexplained bodily symptoms Hypochodriasis – Preoccupation with idea of getting or having a serious disease Body dysmorphic disorder – Preoccupation with imagined or exaggerated physical defect

COPING WITH PAIN What is pain? Coping mechanisms Complex determination involving biological, psychological, and social factors Coping mechanisms Active coping Passive coping Treating pain disorders Reduce anxiety Psychological interventions Cognitive behavioral therapy, biofeedback, insight psychotherapy Pain medication

SOMATIZATION DISORDERS Multiple somatic complaints that are recurrent or chronic Formerly known as Briquet’s syndrome Seek treatment for multiple physical complaints that do not appear to be feigned DSM-IV requires at least four pain symptoms in different bodily sites and gastrointestinal and sexual nonpain complaints Occurs mainly in women – One percent of female population Seems to run in families Cognitive and psychodynamic therapies are often effective

SURGERY IN SOMATIZING PATIENTS

CONVERSION DISORDERS Patients report loss of some bodily function Does not appear to be voluntary Not explained by physical causes or related to a medical condition Patient often unconcerned about the symptom Frequently traced to specific triggering events

HYPOCHONDRIASIS Persistent belief of having serious illness in spite of reassurance and no physical finding Preoccupation with condition of bodily organs Constant worry about health Attune to most subtle physiological functions Cognitive-behavioral therapy is helpful

BODY DYSMORPHIC DISORDER Disorder of body image Preoccupation with imagined bodily defect or excessive concerns about minor unwanted feature Patients report feelings of depression, phobias, obsessions and compulsions but don’t mention bodily preoccupations Cognitive-behavioral therapy is promising.

FACTITIOUS DISORDERS AND MALINGERING Patients with these disorders usually have lifelong, severe personality disorders Munchausen syndrome Physical and psychological symptoms are voluntarily self-induced in order to receive medical attention Factitious disorder by proxy Usually a mother producing symptoms in a child in order to get attention for the mother Malingering Seek treatment for specific goal such as compensation, disability payments, or evasion of police.