Treatment of Somatic Symptom and Related Disorders

Treatment of Somatic Symptom and Related Disorders

• Somatic Symptom Disorder and Illness Anxiety Disorder: Treatment involves reassurance, education, and reducing help-seeking behaviors. Cognitive-Behavioral Therapy (CBT) and antidepressant medications (SSRIs, such as paroxetine) are also effective.

Treatment of Dissociative Disorders

• Depersonalization-Derealization Disorder: Psychological treatments similar to those for panic disorder are helpful, and addressing stressors associated with the disorder's onset is essential.
• Dissociative Fugue: Treatment involves recalling events during the amnesic or fugue state, often with the help of friends and family, and using hypnosis or benzodiazepines to aid in memory recovery.
• Dissociative Identity Disorder: Treatment involves identifying and neutralizing cues that trigger memories of trauma, confronting and reliving the trauma, and using hypnosis to access unconscious memories.

Treatment of Mood Disorders

• Depression: Antidepressant medications, including SSRIs (e.g., fluoxetine), mixed reuptake inhibitors (e.g., venlafaxine), tricyclic antidepressants (e.g., imipramine), and monoamine oxidase inhibitors (e.g., phenelzine), are effective treatments.
• Electroconvulsive Therapy (ECT): A controversial treatment for treatment-resistant depression, involving the administration of electric shock to the brain to produce a seizure.

Treatment of Eating Disorders

• Bulimia Nervosa: Fluoxetine (Prozac) is an effective medication, and cognitive-behavioral treatments (e.g., CBT-E) and interpersonal psychotherapy (IPT) are also helpful.
• Binge-Eating Disorder: Cognitive-behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are effective treatments.
• Anorexia Nervosa: The primary goal is to restore the patient's weight, and cognitive-behavioral therapy (CBT) is a helpful treatment approach.

Treatment of Sleep-Wake Disorders

• Insomnia: Medical treatments include benzodiazepines (e.g., triazolam) and non-benzodiazepines (e.g., zaleplon), and psychological treatments include cognitive-behavioral therapy (CBT) and relaxation techniques.

Treatment of Anxiety Disorders

• Generalized Anxiety Disorder: Benzodiazepines and antidepressant medications (SSRIs) are effective treatments, and cognitive-behavioral therapy (CBT) and relaxation techniques are also helpful.
• Panic Disorder and Agoraphobia: Gradual exposure exercises and cognitive-behavioral therapy (CBT) are effective treatments, and medications such as antidepressants and benzodiazepines can be used in conjunction with therapy.

Treatment of Trauma and Stressor-Related Disorders

• Posttraumatic Stress Disorder (PTSD): Psychoanalytic therapy, cognitive-behavioral therapy (CBT), and exposure and response prevention (ERP) are effective treatments, and medications such as antidepressants and anxiolytics can be used in conjunction with therapy.

Treatment of Obsessive-Compulsive and Related Disorders

• Obsessive-Compulsive Disorder (OCD): Exposure and response prevention (ERP) is a highly effective treatment, and medications such as clomipramine (Anafranil) and selective serotonin reuptake inhibitors (SSRIs) are also effective.

Treatment of Personality Disorders

• Borderline Personality Disorder: Dialectical behavior therapy (DBT) and cognitive-behavioral therapy (CBT) are effective treatments, and medications such as antidepressants and mood stabilizers can be used in conjunction with therapy.

Treatment of Substance-Related Disorders

• Principles of Effective Treatment: No single treatment is right for everyone, and treatment should be readily available, address multiple needs, and be continually assessed and modified.
• Medical Treatments: Medications such as methadone, buprenorphine, and nicotine replacement therapy can be effective in treating substance use disorders.

Treatment of Gender Dysphoria

• Treatment of Gender Dysphoria: Psychological evaluation and education, hormone therapy, and sex reassignment surgery are effective treatments for gender dysphoria.### Recovery Programs
• AA (Alcoholics Anonymous) is a program of recovery from alcoholism only
• AA's 12 Steps: tried to carry the message to alcoholics and practice principles in all affairs

Alternative Recovery Programs

• Cocaine Anonymous and Narcotics Anonymous
• Rational Recovery
• Moderation Management
• Women for Sobriety
• SMART Recovery
• Component Treatment
• Contingency Management: clinician and client select behaviors to change and reinforcers to reward goals
• Community Reinforcement Approach: addresses multiple aspects of drug problem to help identify and correct contributing factors

Treatment of Schizophrenia

• In Kenya, traditional healers use unique methods to treat hallucinations
• Biological Interventions:
  • Insulin Coma Therapy: abandoned due to high risk of illness and death
  • Psychosurgery: not effective
  • Electroconvulsive Therapy (ECT)
  • Transcranial Magnetic Stimulation: treats hallucinations using magnetic fields
  • Antipsychotic Medications:
    • Neuroleptics: dopamine antagonists, first-generation (e.g., Haldol, Thorazine) and second-generation (e.g., Risperidone, Olanzapine)
• Psychosocial Interventions:
  • Clinicians teach social skills, divide complex skills into parts, and practice role-playing
  • Programs teach adapting to disorder and living in the community
  • Virtual assessments and treatments provide controlled environments
  • Behavioral family therapy: educates family about schizophrenia, relieves guilt, and improves communication skills
  • Vocational Rehabilitation: supportive employment with coaches for job training
  • Assertive Community Treatment (ACT) Program: multidisciplinary team provides broad treatment

Treatment of Neurodevelopmental Disorders

• Attention-Deficit/Hyperactivity Disorder (ADHD):
  • Psychosocial Interventions: improve academic performance, decrease disruptive behavior, and teach social skills
  • Reinforcement programs: reward improvements, punish misbehavior

Treatment of Personality Disorders

• Cluster A Personality Disorders:
  • Paranoid Personality Disorder: unlikely to seek help, therapy focuses on trust and cognitive therapy
  • Schizoid Personality Disorder: rare to seek treatment, therapy focuses on social relationships and empathy
  • Schizotypal Personality Disorder: treatment includes medical and psychological treatments for depression, social skills training, and antipsychotic medication
• Cluster B Personality Disorders:
  • Antisocial Personality Disorder: rare to identify as needing treatment, therapy focuses on incarceration and identifying high-risk children
  • Borderline Personality Disorder: symptomatic treatment using drugs, therapy focuses on distress and seeking treatment
• Cluster C Personality Disorders:
  • Avoidant Personality Disorder: behavioral intervention techniques for anxiety and social skills problems
  • Dependent Personality Disorder: therapy focuses on independence and decision-making
  • Obsessive-Compulsive Personality Disorder: therapy attacks underlying fears

Other Personality Disorder Treatments

• Mood stabilizers
• Anticonvulsive and antipsychotic drugs
• Cognitive-Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)

Treatment of Neurocognitive Disorders

• Tourette's Disorder: psychological intervention, self-monitoring, relaxation training, and habit reversal
• Delirium: haloperidol or antipsychotic medication, psychosocial intervention to reassure and maintain control
• Neurocognitive Disorder due to Alzheimer's Disease: management involves lists, maps, and notes to maintain orientation, new medications prevent acetylcholine breakdown and delay decline

Helpful Strategies for Managing Behavioral Challenges

• Teaching Families to Respond Constructively: encourage parents to respond constructively and structure the child's day
• Cognitive-Behavioral Therapy (CBT): reduces distractibility and improves organizational skills, helpful for ADHD in adults
• Biological Interventions: stimulants (e.g., Ritalin, Adderall), non-stimulant medications (e.g., Atomoxetine, Guanfacine), and specific learning disorder interventions
• Direct Instruction: systematic instruction in small groups, mastery teaching
• Autism Spectrum Disorder: psychosocial treatments focus on skill building, communication, and socialization, biological treatments include major tranquilizers and SSRIs

Learn about the treatment approaches for Somatic Symptom Disorder, Illness Anxiety Disorder, Conversion Disorder, and other related disorders, including cognitive-behavioral therapy and medication.