DISORDERS OF BODILY PREOCCUPATION

1
Chapter 6

• DISORDERS OF BODILY PREOCCUPATION

2
DSM-IV DISORDERS

• PAIN DISORDER
• SOMATOFORM DISORDER
• FACTITIOUS DISORDER AND MALINGERING

3
SOMATOFORM DISORDERS

• Pain disorder Psychological factors play a
  large role in pain
• Somatization disorder Multiple complaints over
  a period of years
• Conversion disorder Unexplained bodily symptoms
• Hypochodriasis Preoccupation with idea of
  getting or having a serious disease
• Body dysmorphic disorder Preoccupation with
  imagined or exaggerated physical defect

4
COPING WITH PAIN

• What is pain?
• Complex determination involving biological,
  psychological, and social factors
• Coping mechanisms
• Active coping
• Passive coping
• Treating pain disorders
• Reduce anxiety
• Psychological interventions
• Cognitive behavioral therapy, biofeedback,
  insight psychotherapy
• Pain medication

5
SOMATIZATION DISORDERS

• Multiple somatic complaints that are recurrent or
  chronic
• Formerly known as Briquets syndrome
• Seek treatment for multiple physical complaints
  that do not appear to be feigned
• DSM-IV requires at least four pain symptoms in
  different bodily sites and gastrointestinal and
  sexual nonpain complaints
• Occurs mainly in women One percent of female
  population
• Seems to run in families
• Cognitive and psychodynamic therapies are often
  effective

6
SURGERY IN SOMATIZING PATIENTS
7
CONVERSION DISORDERS

• Patients report loss of some bodily function
• Does not appear to be voluntary
• Not explained by physical causes or related to a
  medical condition
• Patient often unconcerned about the symptom
• Frequently traced to specific triggering events

8
HYPOCHONDRIASIS

• Persistent belief of having serious illness in
  spite of reassurance and no physical finding
• Preoccupation with condition of bodily organs
• Constant worry about health
• Attune to most subtle physiological functions
• Cognitive-behavioral therapy is helpful

9
BODY DYSMORPHIC DISORDER

• Disorder of body image
• Preoccupation with imagined bodily defect or
  excessive concerns about minor unwanted feature
• Patients report feelings of depression, phobias,
  obsessions and compulsions but dont mention
  bodily preoccupations
• Cognitive-behavioral therapy is promising.

10
FACTITIOUS DISORDERSAND MALINGERING

• Patients with these disorders usually have
  lifelong, severe personality disorders
• Munchausen syndrome
• Physical and psychological symptoms are
  voluntarily self-induced in order to receive
  medical attention
• Factitious disorder by proxy
• Usually a mother producing symptoms in a child in
  order to get attention for the mother
• Malingering
• Seek treatment for specific goal such as
  compensation, disability payments, or evasion of
  police.