1. Somatic Symptom Disorders
Chapter 17
Somatic Symptom Disorders
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

2. Clinical Picture Somatic symptom disorder (SSD)
Illness anxiety disorder (previously hypochondriasis)
Conversion disorder
Psychological factors affecting medical condition
Factitious disorder
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

3. Somatic Symptom Disorder
Distressing symptoms
Maladaptive response
Without significant physical findings and medical diagnosis
Suffering is authentic
High level of functional impairment
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

4. Illness Anxiety Disorder
Misinterpretation of physical sensations
Overconcerned for health and preoccupied with symptoms
Extreme worry and fear
Course of illness chronic and relapsing
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

5. Conversion Disorder
Neurological symptoms in the absence of a neurological diagnosis
Presence of deficits in voluntary motor or sensory functions
Common symptoms—paralysis, blindness, movement and gait disorders, numbness, paresthesias, loss of vision or hearing, or episodes resembling epilepsy
“La belle indifférence” versus distress
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

6. Psychological Factors Affecting Medical Condition
Psychological factors present risk for medical diseases
Depression
Cardiovascular diseases and cancer
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

7. Etiology Biological factors Psychological factors
Genetic
Psychological factors
Psychodynamic theories
Behavioral theories
Cognitive theories
Environmental factors
Cultural considerations
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

8. Application of the Nursing Process
Assessment
Psychosocial factors
Coping skills
Spirituality and religion
Secondary gains
Cognitive style
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

9. Application of the Nursing Process (Cont.)
Assessment (cont.)
Ability to communicate feelings and emotional needs
Dependence on medication
Self-assessment
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

10. Application of the Nursing Process (Cont.)
Nursing diagnosis
Ineffective coping
Outcomes identification
Interventions
Psychosocial interventions
Promotion of self-care activities
Assertiveness training
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

11. Application of the Nursing Process (Cont.)
Interventions (cont.)
Psychobiological interventions
Pharmacological interventions
Health teaching and health promotion
Case management
Advanced nursing practice interventions
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

12. Factitious Disorders
Artificially, deliberately, and dramatically fabricate symptoms or self-inflict injury
Goal of assuming a sick role
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

13. Examples of Factitious Disorders
Self-directed
Other-directed
Malingering
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.

14. Audience Response Questions
Which problem does NOT fit the group?
Conversion disorder (functional neurological disorder)
Illness anxiety disorder (hypochondriasis)
Munchausen syndrome by proxy
Somatic symptom disorder
ANS: C
Munchausen by proxy is a factitious disorder. The distracters are somaticization disorders.
REF: 325,
Copyright © 2014, 2010, 2006 by Saunders, an imprint of Elsevier Inc.