Somatoform & Adjustment Disorders PDF

Somatoform and Adjustment Disorders Dr. Madawi Alotaibi  Somatoform Disorders But I do! You have no symptoms! No clear medical cause?? soft new aim daffert emit ...

Somatoform and Adjustment Disorders Dr. Madawi Alotaibi  Somatoform Disorders But I do! You have no symptoms! No clear medical cause?? soft new aim daffert emit  F What is it??? Somatoform is a disorder where you think you have physical symptoms, but none are found SD are mental illnesses that cause physical symptoms, most commonly pain Their symptoms are severe enough to interfere with everyday functioning Affecting multiple organs systems Not proven to have a medical cause (complete medical examination)…emotionally based me Characterized by early onset and chronic condition with no physical changes occur over time Significant impairment occurs in social and occupational functioning Symptoms lasting for more than 6 months  Facts Prevalence: 0.2- 2% among women; < 0.2 among men Most common among unmarried, female, & from lower SES groups T Ten First presenting before 30 eeanbyadoltchord Emer ue illness societies  1 Etiological factors u Genetic factors Early traumatic experiences (violence, abuse) jun can The personality trait of negativity Learned behavior ñ Economic issues  Risk factors Having anxiety or depression Having a medical condition or recovering from one Being at risk of developing a medical condition, such as having a strong family history of a disease Experiencing stressful life events, trauma, or violence and  Classifications 1. Somatization disorder 2. Conversion disorder 3. Factitious Disorder 4. Pain disorder 5. Body dysmorphic disorder 6. Hypochondriasis  Somatization disorder inmates Hysteria Persons with somatization disorder can have various physical symptoms related to any body part such as pain, nausea, vomiting, bloating, headaches, sexual dysfunction, irregular menstruation, and balance problems.  Somatization disorder  Present in a medical rather than the psychiatric setting refine  Should receive a thorough medical evaluation  Beginning before 30  Occurring over several years  At least 4 pain sits  At least 2 gastrointestinal signs & symptoms (nausea, vomiting, diarrhea, heartburn, constipation)  At least one sexual sign & symptom other than pain (difficulties with erection, painful urination)  At least one neurological sign & symptom (seizures, impaired balance, paralysis) No organic basis for the symptoms is validated  Somatic symptom disorder The diagnostic criteria for Somatic Symptom Disorder noted in DSM 5 are: A. One or more somatic symptoms that are distressing or result in significant disruption of daily life. B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health so concerns as manifested by at least one of the following: Disproportionate and persistent thoughts about the seriousness of one’s symptoms. Persistently high level of anxiety about health or symptoms. Excessive time and energy are devoted to these symptoms or health concerns. C. Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months).  Conversion disorder (functional neurological symptom disorder) as variations This is a somatic symptom disorder where a person actually loses a sensory or motor bodily function, resulting in blindness, deafness, paralysis, or numbness or sometimes suffering from seizures. Not making up their symptoms Happened after situation that produce extreme psychological stress Emily who believes it is not acceptable to have violent feelings may suddenly feel numbness in her arms after becoming so angry that she wanted to hit someone.  Conversion disorder (functional neurological symptom disorder) The diagnostic criteria for Conversion Disorder noted in DSM 5 are: A. One or more symptoms of altered voluntary motor or sensory function. B. Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions. C. The symptom or deficit is not better explained by another medical or mental disorder. D. The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation.  Types F.EE i i syndrome)if Factitious Disorder (Munchausen Factitious Disorder Imposed on Self Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. The individual presents himself or herself to others as ill, impaired, or injured. The deceptive behavior is evident even in the absence of obvious external rewards. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.  Factitious Disorder (Munchausen syndrome) Factitious Disorder Imposed on Another Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception. The individual presents another individual (victim) to others as ill, impaired, or injured. The deceptive behavior is evident even in the absence of obvious external rewards. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder. Note: The perpetrator, not the victim, receives this diagnosis. IEEE4  Pain disorder Persons suffering from pain disorder suffer from severe, chronic pain for which no physical cause can be found. Cause social and occupational impairment Triggered by psychological trauma  Body dysmorphic disorder The afflicted person is unduly concerned with body image, manifesting as excessive concern about and preoccupation with a perceived defect of their physical appearance that is not very obviously apparent to others. there Most common in teenagers and young adults lationalup Symptoms of BDD include: cheatins EET Constantly checking yourself in the mirror. Avoid mirrors. Trying to hide your body part under a hat, scarf, or makeup. Constantly exercising or grooming. Constantly comparing themselves with others. Always ask other people whether they look OK.  Case study Ever Chloe, a 19-year-old college student, seeks therapy due to intense anxiety and preoccupation with her perceived flaws in appearance. She spends hours daily examining herself in the mirror, fixated on minor imperfections like a small scar on her nose or the shape of her eyebrows. She believes others constantly stare at her flaws and avoids social situations due to this fear. Background Information: Chloe has been self-conscious about her appearance for several years. What started as occasional worries about her looks has escalated into a constant and intrusive obsession. She spends a significant amount of time researching cosmetic procedures and makeup techniques to "fix" her perceived flaws. These anxieties significantly impact her studies and social life. Diagnostic Impression: Based on Chloe's preoccupation with perceived flaws in her appearance, despite these flaws being minimal or not noticeable to others, and the resulting distress and social avoidance, the therapist diagnoses Chloe with Body Dysmorphic Disorder (BDD).  Hypochondriasis miss in not nyon age as Persons with hypochondriasis often imagine that they suffer from a serious illness when they experience minor symptoms. Symptoms last for 6 months eating meters Doctor shopping Following a true illness or losing a loved one Is or 0 Associated with depressive or anxiety disorder Men= women Bloating sensation or I am having stomach indigestion cancer dating  Somatoform Disorders Treatment Medications Supportive psychotherapy (group treatment) Cognitive behavioral therapy Teach of distraction strategies Hypnotherapy Physical therapy Hot or cold packs Acupuncture Electrotherapy Massage therapy Stress-reduction activities include meditation  Adjustment Disorder Adjustment disorder is an excessive reaction to a stressful or traumatic event The stressors could be single or multiple events Stressors can also be recurrent Individual or groups Short-term condition Symptoms improve with time  Diagnosis Meet the following five DSM-5 criteria: Emotional or behavioral symptoms developed within 3 months of the start of the stressful event Emotional or behavioral symptoms are clinically significant. Symptoms don’t meet the criteria for another mental disorder Symptoms are not part of a normal grieving process. Symptoms don’t last more than 6 months after the triggering event has ended  Adjustment Disorder Affect 2 to 8% of the general population Affect anyone at any age Females twice as males  Types Adjustment disorder with depressed mood: Symptoms include feelings of sadness, hopelessness, crying, and lack of joy from previous pleasurable things. Adjustment disorder with anxiety: Symptoms include feeling worried, anxious, overwhelmed & trouble concentrating. Separation anxiety is a dominant symptom in children. Adjustment disorder with mixed anxiety and depressed mood: Symptoms include feeling both anxious and depressed. Adjustment disorder with disturbance of conduct: Symptoms include behavioral issues such as acting rebellious, destructive, reckless, or impulsive. Adjustment disorder with mixed disturbance of emotions and conduct: Symptoms include anxiety, depression, and behavioral issues. Adjustment disorder unspecified: Symptoms include physical symptoms such as headaches, body aches, stomach aches, heart palpitations, or insomnia.  Complications of adjustment disorder Untreated …… higher risk of suicide attempt or thoughts of suicide  Treatment Medications Psychotherapy Individual, family, or group therapy Support groups CPT  Case study Sarah, a 16-year-old high school student, presents to therapy with her parents due to sudden changes in behavior and mood. She has become withdrawn and irritable, arguing frequently with her parents and neglecting her schoolwork. These changes began shortly after her parents announced their upcoming divorce. Background Information: Sarah has always been a well-adjusted student with a good social life. She enjoys participating in extracurricular activities and maintains good grades. However, since her parents' announcement, Sarah has become increasingly withdrawn and tearful. Her grades have slipped, and she has isolated herself from her friends. Diagnostic Impression: Based on the onset of emotional and behavioral symptoms following a significant stressor (parents' divorce), the therapist diagnoses Sarah with Adjustment Disorder. Adjustment Disorder is a temporary emotional and behavioral reaction to a stressful life event. It's important to distinguish this from other mental health disorders, as symptoms typically resolve within 6 months of the stressor subsiding.  What’s the difference between adjustment disorder and major depression and generalized anxiety disorder? very Ires  What’s the difference between adjustment disorder and post-traumatic stress disorder (PTSD)?  Activity A 19-year-old female college student was brought to the hospital after a suicide attempt related to her obsessive preoccupation with her facial appearance. Her mom reported that she believed her face was so ugly that it required a skin graft. Two years earlier, at the age of 17, she had developed acne. From that time onward she experienced disturbed sleep and become increasingly preoccupied with the appearance of her face. She had repetitive thoughts such as, "If I squeeze my pimples today, they will grow back tomorrow. I cannot deal with my acne." During the past 18 months, she increasingly believed that her face had turned ugly and her skin pores were overly enlarged. She would spend four to six hours per day checking her facial skin, sometimes washing it 5-6 times daily. She told others, "If I wash my face often enough, maybe my skin pores will shrink in size." She repetitively looked in the mirror and said she felt scared when looking at her 'ugly' face. Several times she had scheduled cosmetology consultations to ask plastic surgeons to perform a skin graft, but she was told there was no reason for treatment. However, she continued to believe that her facial pores were grossly enlarged and that others made fun of her because of this. bades i  Activity A 53-year-old woman comes with “discrete right-sided breast mass”. She says that she discovered it in the shower 9 months ago, & has been to 6 different physicians for evaluation. None of the other physicians were able to palpate this mass and so they told her that it must be “in her head”. She told you that her best friend died of breast cancer a year ago.  ‫ﺷﻛرا ً ﻟﻛم‬ Thank You