Somatic Symptom Illnesses PDF

SOMATIC SYMPTOM ILLNESSES GROUP 5 GROUP 5 MEMBERS Angco, Alysia Chloe A. Chiyuto, Xyrel Ane Mae T. Galeliaga, Jillien Cleire M. Jo, John Delfin D. Manzano, Mars Cesandra R. Sampan, Dinesse Trisha Louise C. INTRODUCTION Psychosomatic used to convey the...

SOMATIC SYMPTOM ILLNESSES GROUP 5 GROUP 5 MEMBERS Angco, Alysia Chloe A. Chiyuto, Xyrel Ane Mae T. Galeliaga, Jillien Cleire M. Jo, John Delfin D. Manzano, Mars Cesandra R. Sampan, Dinesse Trisha Louise C. INTRODUCTION Psychosomatic used to convey the connection between the mind (psyche) and the body (soma) in states of health and illness. In the early 1800s, the medical field began to consider the various social and psychological factors that influence illness. The mind can cause the body either to create physical symptoms or to worsen physical illnesses.  Real symptoms can begin, continue, or be worsened as a result of emotional factors  Hysteria refers to multiple physical complaints with no organic basis The concept of hysteria is believed to have originated in Egypt and is about 4,000 years old. In the Middle Ages, hysteria was associated with witchcraft, demons, and sorcerers. Paul Briquet and Jean- Martin Charcot, both French physicians, identified hysteria as a disorder of the nervous system. Sigmund Freud and Charcot - observed that people with hysteria improved with hypnosis and experienced relief from their physical symptoms when they recalled memories and expressed emotions. This development led Freud to propose that people can convert unexpressed emotions into physical symptoms, a process now referred to as SOMATIZATION OVERVIEW  Somatization defined as the transference of mental experiences and states into bodily symptoms. Somatic symptom illnesses can be characterized as the presence of physical symptoms that suggest a medical condition without a demonstrable organic basis to account fully for them. Somatic symptom disorders include SOMATIC SYMPTOM DISORDER characterized by one or more physical symptoms that have no organic basis FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDER formerly called conversion reaction or disorder, involves unexplained, usually sudden deficits in sensory or motor function la belle indifférence - a seeming lack of concern or distress, about the functional loss. PAIN DISORDER has the primary physical symptom of pain, which is generally unrelieved by analgesics and greatly affected by psychological factors in terms of onset, severity, exacerbatio, and maintenance. ILLNESS ANXIETY DISORDER formerly hypochondriasis, is preoccupation with the fear that one has a serious disease (disease conviction) or will get a serious disease (disease phobia).  Onset and Clinical course Somatic symptom disorder: onset in adolescence, diagnosed by 25. Functional neurological symptom disorder: occurs between 10-35 years. Pain disorder and illness anxiety disorder: can occur at any age. Somatic symptoms are chronic or recurrent. Clients seek mental health help after failing to find a medical diagnosis. Related Disorder Somatic symptom illnesses differ from malingering and factitious disorders, as clients do not intentionally control or produce their symptoms, unlike in the latter conditions. Factitious disorder (Munchausen syndrome): Malingering involves Intentional production of symptoms to gain attention, deliberately faking or sometimes causing self-harm. exaggerating symptoms for external benefits, such as Munchausen syndrome by proxy: Inflicting illness on others to gain attention or appear heroic. avoiding work, legal issues, or obtaining money or drugs. Medically unexplained symptoms (MUS) refer to Symptoms cease once the physical symptoms with no medical diagnosis, often desired outcome is preferred by patients over psychosomatic labels, and achieved. effective treatment involves empathy, coping strategies, and provider support PSYCHOSOCIAL THEORIES INTERNALIZATION: Keeping stress, anxiety, or frustration inside instead of expressing them outwardly. SOMATIZATION: Expression of internal stress through physical symptoms. ALEXITHYMIA: Inability to identify or express emotions verbally. PRIMARY GAINS: Internal benefits from being sick, such as relief from anxiety or distress. SECONDARY GAINS: External benefits received due to illness, like attention or comfort from others. Somatization is associated most often with women, as evidenced by the old term hysteria (Greek for “wandering uterus”). Take it like a man Women seek medical treatment more often than men Childhood sexual abuse Women more often receive treatment for psychiatric disorders with strong somatic components BIOLOGICAL THEORIES  1. Stimulus Regulation Issues: Difficulty distinguishing relevant from irrelevant stimuli. 2. Amplified Sensory Awareness: Heightened perception of bodily sensations. 3. Pathologic Interpretation of Normal Sensations: Misinterpreting regular bodily functions as signs of illness. 4. Visceral Hypersensitivity: Increased sensitivity to internal bodily sensations, especially in the gastrointestinal (GI) tract. TREATMENT Focus of Treatment Build a trusting relationship to prevent "doctor shopping." Show empathy and address physical complaints sensitively. Depression and anxiety are common; treat holistically. Medication Management Antidepressants (Selective Serotonin Reuptake Inhibitors) Drug Dose (mg/day) Side Effects Rash, headache, anxiety, insomnia, nausea, Fluoxetine (Prozac) 20–60 loss of appetite; avoid alcohol Nausea, dizziness, dry mouth, sweating, Paroxetine (Paxil) 20–60 sexual dysfunction; avoid alcohol Nausea, diarrhea, headache, insomnia, sexual Sertraline (Zoloft) 50–200 dysfunction; avoid alcohol Pain Management Referral to chronic pain clinics for relaxation & visualization techniques. Use physical therapy for muscle tone improvement. Avoid narcotics; recommend NSAIDs for pain relief. Therapy and Education Prognosis Somatic illnesses are often chronic or Cognitive Behavioral Therapy (CBT) recurrent: Effective for managing symptoms, improving emotional health, and addressing health anxiety. Conversion disorder may remit within weeks but recurs in 25% of cases Group Therapy Somatic symptom disorder, illness anxiety disorder, and pain disorder often last for Peer support and coping strategies. years Educational Resources Online materials and books for self-help. COMMUNITY-BASED CARE Health Professional's Role Build trust with clients. Provide empathy and validate complaints. Key Interventions Make referrals to pain clinics or support groups. Suggest engaging in hobbies or pleasurable activities. MENTAL HEALTH PROMOTION Understanding Somatic Symptoms Symptoms arise when emotional conflicts and stress are expressed physically. Encouraging direct expression of emotions can help reduce symptoms. Impact of Knowledge and the Internet Increased public awareness promotes self-understanding and behavior change. Cyberchondria: Anxiety worsened by excessive online health searches. Application Of The Nursing Process Assessment Assessment Not bothered at all = 0 Bothered a little = 1 Bothered a lot = 2 Stomach pain Dizziness Constipation, loose Back pain Fainting spells stools, or diarrhea Pain in arms, legs, and Heart racing or Nausea, gas, or joints pounding indigestion Menstrual cramps SOB Feeling tired or having Headaches Problems during low energy Chest pain sexual intercourse Trouble sleeping History Clients often provide a lengthy, detailed account of: Previous physical problems Numerous diagnostic tests Multiple surgical procedures Commonly have consulted numerous healthcare providers over several years. May express dismay or anger at the medical community, with comments like: “They just can’t find out what’s wrong with me.” “They’re all incompetent, and they’re trying to tell me I’m crazy!” Clients with conversion disorder may exhibit la belle indifference (little emotion when describing limitations or lack of diagnosis). General Appearance & Mood & Affect Motor Behavior Mood is often labile Depressed and sad when Walks slowly or with an unusual gait describing physical problems Facial expression of discomfort or Bright and excited when talking physical distress about how they had to go to the Describes their complaints in hospital colorful, exaggerated terms, but Emotions are often exaggerated lacks specific information Thought Process and Content Illness Anxiety Disorder Physical symptoms are often Focuses on the fear of serious exaggerated (e.g., mistaking a illness, not the actual illness. cold for pneumonia). Discussions may include Hypochondriasis features extreme scenarios, such as Obsession with bodily planning funerals for minor functions and medical illnesses. information. Limited ability to recognize or Unrealistic fears of infection or discuss emotional feelings. prescription medications.  Judgment and Insight Exaggerated responses to Sensorium and physical health can impact clients' Intellectual Processes judgment. Clients may have little or no Clients are alert and oriented. insight into their behavior. Intellectual functions are They are convinced their problem unimpaired. is solely physical. They often believe others don't understand their condition.  Self-Concept Nursing Dx Focus primarily on the physical Ineffective Coping: aspect of themselves Inability to form a valid appraisal of Tends to have low self-esteem the stressors, inadequate choices and avoid acknowledging it of practiced responses, and/or Experience difficulty in work inability to use available resources and struggle with daily life management, which they relate solely to their physical status Implementation Nursing Intervention Rationale The initial nursing assessment should include a complete physical assessment, a The nursing assessment history of previous complaints and provides a baseline from which to begin treatment, and a consideration of each planning care. current complaint. Help the client identify and use nonchemical Shifts the focus of coping away from methods of pain relief, such as relaxation. medications and increases the client's sense of control. Encourage the client to discuss his or her The focus is on feelings of fear, not fear of feelings about the fears rather than the physical problems. fears themselves. Understanding and Managing Somatic Symptom Illnesses An Overview of Roles, Challenges, and Interventions in Nursing ROLES AND RELATIONSHIPS Clients often face unemployment due to absenteeism or inability to work. Social isolation: Limited family support and few social interactions. Challenges in family dynamics: Lack of understanding and frustration with client complaints. Impact on home life: Chaos and unpredictability. PHYSIOLOGICAL AND SELF-CARE CONCERNS Legitimate needs despite numerous physical complaints. Common issues: Disturbed sleep patterns, poor nutrition, lack of exercise. Risks associated with medications: Withdrawal from anxiolytics or pain relievers. Nurses' role in addressing these needs holistically. _______ ANXIETY _________ _____ _______ DISTURBED SLEEP PATTERN ____ PAIN DATA ANALYSIS Common nursing diagnoses for clients who somatize: Ineffective coping Ineffective denial Impaired social interaction Anxiety Disturbed sleep pattern Fatigue Pain Risk of disuse syndrome in clients with conversion disorder due to inactivity OUTCOME IDENTIFICATION Recognize the relationship between stress and physical symptoms. Verbalize emotional feelings effectively. Establish and follow a daily routine. Adopt healthier behaviors: Stress management, better nutrition, improved activity levels.  INTERVENTION Providing Health Teaching Assisting in Emotional Expression Establish daily routines with Teach the connection between adequate rest, nutrition, and stress and physical symptoms. exercise. Encourage journaling to identify Encourage gradual participation in stressors and symptom triggers. physical and social activities. Shift focus from physical Use collaboration and validation complaints to emotional feelings. techniques to motivate behavior Provide positive feedback to changes. encourage emotional Example dialogues to engage clients exploration. in activities and better habits. Teaching Coping Strategies Emotion-Focused Strategies: Deep breathing, guided imagery, and distractions. Problem-Focused Strategies: Teach problem-solving methods. Role-play social interactions to build confidence in relationships. Plan solutions for stressful life situations (e.g., scheduling tasks to balance effort and enjoyment). CLIENT AND FAMILY EDUCATION Establish routines for health: Rest, exercise, and nutrition. Educate about the mind-body relationship and stress management. Teach relaxation techniques like progressive relaxation and guided imagery. Role-play social interactions to improve communication. Encourage families to support positive behaviors and avoid reinforcing the sick role. EVALUATION Somatic symptom illnesses are chronic or recurrent, requiring slow progress. Positive indicators of progress: Fewer visits to physicians for physical complaints. Reduced medication use and increased use of coping strategies. Improved functional abilities and social relationships. Evaluate changes over time and adapt interventions as needed. THANK YOU FOR LISTENING!