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Questions and Answers
What is the primary characteristic of functional disorders?
What is the primary characteristic of functional disorders?
Which of the following is NOT a functional somatic syndrome?
Which of the following is NOT a functional somatic syndrome?
How many different principles are used to construct diagnostic constructs for functional somatic syndromes?
How many different principles are used to construct diagnostic constructs for functional somatic syndromes?
What is a common feature of functional somatic syndromes across different specialties?
What is a common feature of functional somatic syndromes across different specialties?
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What is the term used to describe patients who frequently attend healthcare services with functional somatic syndromes?
What is the term used to describe patients who frequently attend healthcare services with functional somatic syndromes?
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What is Central Sensitivity Syndrome also known as?
What is Central Sensitivity Syndrome also known as?
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What is the main characteristic of Central Sensitization?
What is the main characteristic of Central Sensitization?
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What is the minimum duration required for a symptoms to be classified as Bodily Distress Syndrome?
What is the minimum duration required for a symptoms to be classified as Bodily Distress Syndrome?
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What is the term used to describe the concept of medically unexplained symptoms in DSM-IV?
What is the term used to describe the concept of medically unexplained symptoms in DSM-IV?
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What is the term used to describe the disorder in DSM-5, which was previously known as Somatoform Disorder?
What is the term used to describe the disorder in DSM-5, which was previously known as Somatoform Disorder?
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Study Notes
Functional Disorders
- Functional disorders are conditions where an individual experiences somatic symptoms that affect daily functioning or quality of life, and cannot be better explained by another physical disease or psychiatric disorder.
- These disorders are often referred to as "thick folder patients" or frequent attenders.
Functional Somatic Syndromes Across Specialties
- Gastroenterology: Irritable bowel syndrome (IBS), non-ulcer dyspepsia
- Gynaecology: Pelvic arthropathy, premenstrual syndrome, chronic pelvic pain
- Rheumatology: Fibromyalgia, lower back pain
- Cardiology: Atypical or non-cardiac chest pain, syndrome-X
- Respiratory medicine: Hyperventilation syndrome
- Infectious diseases: Chronic fatigue syndrome (CFS, ME), Chronic Lyme disease
- Neurology: Tension headache, non-epileptic seizure
- Dentistry: Temporomandibular joint dysfunction, atypical facial pain
- Ear, nose and throat: Globus syndrome
Common Characteristics of Functional Somatic Syndromes
- Diagnoses are based solely on patients' reports of subjective complaints
- No true biomarkers or paraclinical tests can objectively verify the diagnoses
- Complaints are mainly unspecific symptoms that are common in the general population
Diagnostic Constructs
- Symptoms or symptom count
- Phenotype-symptom pattern/illness picture
- Psychological and behavioural characteristics
- Assumed aetiology (e.g. Central Sensitivity Syndrome)
Bodily Distress Syndrome (BDS)
- Suggested diagnostic criteria: • Types: Multi-organ type (≥3 symptoms from 3-4 organ systems), Single-organ type (≥3 symptoms from 1-2 organ systems) • Symptoms are distressing or cause substantial distress • Relevant differential diagnoses have been ruled out • Duration > 6 months
Bodily Distress Syndrome (BDS) Symptoms
- Cardiopulmonary/autonomic arousal symptoms: ≥3 symptoms (e.g. palpitations, heart pounding, precordial discomfort, breathlessness without exertion, etc.)
- Gastrointestinal arousal symptoms: ≥3 symptoms (e.g. frequent loose bowel movements, abdominal pains, feeling bloated, etc.)
- Musculoskeletal tension symptoms: ≥3 symptoms (e.g. pains in arms or legs, muscular aches or pains, etc.)
- General symptoms: ≥3 symptoms (e.g. concentration difficulties, impairment of memory, fatigue, etc.)
Central Sensitization
- Amplification of neural signaling within the CNS
- Prolonged response leads to a pathological state characterized by a dysfunctional response to different and normally non-noxious stimuli, manifesting as pain hypersensitivity
Etiology of Functional Disorders
- Vulnerability: Biological, psychological, and social heritage, social learning, previous illnesses, sexual abuse
- Triggering factors: Infection or other diseases, physical or psychological trauma, stress or strain
- Maintaining factors: Dysfunctional beliefs about symptoms and illness, dysfunctional illness behavior, hypersensitization and/or dysfunctional processing of symptoms in the CNS, social and economical dependence
Historical Background and Changes from DSM III to DSM 5
- Somatoform Disorder was first introduced 30 years ago in DSM-III
- DSM-IV introduced the concept of medically unexplained symptoms
- DSM-5 replaced Somatoform Disorder with Somatic Symptom Disorder and Related Disorders
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Description
This quiz covers the definition and examples of functional disorders, including irritable bowel syndrome and premenstrual syndrome, which affect daily functioning and quality of life.
