1. DISORDERS OF BODILY PREOCCUPATION
Chapter 6
DISORDERS OF BODILY PREOCCUPATION

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

3. 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

4. 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

5. 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

6. SURGERY IN SOMATIZING PATIENTS

7. 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

8. 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

9. 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.

10. 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.