Questions and Answers
David Browne, Brenda Wright, Guy Molyneux, Mohamed Ahmed, Ijaz Hussain, Bangaru Raju, Michael Reilly in MRCPsych Paper I One-Best-Item MCQs, 2017
Answer: D. In somatisation disorder the patient experiences persistent recurrent multiple physical symptoms starting in early adult life or earlier. There is usually a long history of inconclusive medical and/or surgical investigations and procedures, and high rates of social and occupational impairment. The DSM-IV criteria require four pain symptoms, two gastro-intestinal symptoms, one sexual symptom, and one pseudoneurological symptom for the diagnosis. Conversion disorder involves symptoms or deficits affecting voluntary motor or sensory function, which cannot be fully explained by a general medical condition. Hypochondriasis is distinguished from somatisation disorder by the patient’s preoccupation with the underlying cause rather than symptom relief. Somatoform pain disorder is characterised by persistent severe and distressing pain, at one or more anatomical sites, which is not fully explained by a physical disorder. Patients with major depressive disorder may present with non-specific physical complaints, although these are not predominant in the clinical picture. In all of the above disorders the symptoms are not intentionally produced or feigned, distinguishing them from factitious disorder or malingering. [AH. pp. 229–36]
100 MCQs from Dr. Brenda Wright and Colleagues
David Browne, Selena Morgan Pillay, Guy Molyneaux, Brenda Wright, Bangaru Raju, Ijaz Hussein, Mohamed Ali Ahmed, Michael Reilly in MCQs for the New MRCPsych Paper A, 2017
In somatisation disorder the patient experiences persistent recurrent multiple physical symptoms starting in early adult life or earlier. There is usually a long history of inconclusive medical and surgical investigations as well as high rates of social and occupational impairment. The DSM-IV criteria require four pain symptoms, two gastrointestinal symptoms, one sexual symptom and one pseudoneurological symptom for the diagnosis. Conversion disorder involves symptoms or deficits affecting voluntary motor or sensory function, which cannot be fully explained by a general medical condition. Hypochondriasis is distinguished from somatisation disorder by the patient’s preoccupation with the underlying cause rather than symptom relief. Somatoform pain disorder is characterised by persistent severe and distressing pain at one or more anatomical sites, which is not fully explained by a physical disorder. Patients with major depressive disorder may present with non-specific physical complaints, although these do not dominate the clinical picture. In all of the above disorders, the symptoms are not intentionally produced or feigned, distinguishing them from factitious disorder or malingering. (4, pp 229–36)
Psychiatry and Neurological Disorders
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
The conditions that need to be considered are: Hypochondriasis: the emphasis is on fear of illness. The patient may or not have symptoms (most do), but they are frightened that they have a serious illness.Somatization disorders: symptoms and signs are present in the absence of organic disease sufficient to explain them. If symptoms and signs involve the nervous system then it is likely that they will be labeled as conversion disorder (see below under Dissociation: conversion disorders).Dissociative disorders: this classification has recently been introduced to cover conversion disorders and dissociative states. In both, psychological processes are considered to be dissociated from one another. In the conversion disorders, synonymous with hysteria, typical symptoms and signs include hemiplegia, hemianaesthesia or blindness. The dissociative states consist of psychogenic amnesia, fugue and stuporose states and pseudoseizures.
Depression and anxiety have unique contributions to somatic complaints in depression, irritable bowel syndrome and inflammatory bowel diseases
Published in Psychiatry and Clinical Psychopharmacology, 2019
Ömer Yanartaş, Haluk Tarik Kani, Ayşe Sakallı Kani, Zeynep Nur Demirok Akça, Erdoğdu Akça, Serhat Ergün, Neslihan Tezcan, Özlen Atug, Neşe İmeryüz, Kemal Sayar
As stated above bio-psycho-social factors are quite important in the context of BGA. Psychogenic distress, such as; depression and anxiety has been recurrently studied in inflammatory bowel diseases [23–25] and functional gastrointestinal disorders [17–19]. Moreover, psychosomatic symptoms including headache, fatigue have been widely reported in patients with depression [9,10]. However somatic symptoms, alexithymia, hypochondriasis have not been sufficiently evaluated and recognized among clinicians [26]. Thus, we studied detailed somatic and related symptoms (SARS); alexithymia, hypochondriasis, depression and anxiety in these disorders. Firstly, we evaluated these SARS in patients with depression; which is the most common psychiatric disease, in IBS, the most common functional bowel disease and in IBDs, a typical inflammatory disease of the gastrointestinal tract. Secondly, we compared these groups with each other and with the healthy control group. Our hypotheses were; (i) Somatic symptoms and alexithymia would be highest in depressive disorder patients, (ii) Somatic symptoms and alexithymia would be significantly higher in IBS patients than IBDs patients (iii) Somatic symptoms would be correlated with depression, anxiety, alexithymia and hypochondriasis in all groups.
From hypochondrium to hypochondria
Published in Journal of the History of the Neurosciences, 2023
Régis Olry
As for “hypochondriasis,” it is more difficult to define in just a few words. Moreover, it should be noted that the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has replaced this term with “illness anxiety disorder” and “somatic symptom disorder.” One recent definition among numerous others is that hypochondriasis is “a preoccupation with having a serious disease based on a misinterpretation of bodily symptoms” (Meng et al. 2019, 2).
Childhood and family factors in the development of health anxiety: A systematic review
Published in Children's Health Care, 2018
Mette Viller Thorgaard, Lisbeth Frostholm, Charlotte Ulrikka Rask
Excessive HA is a central feature of hypochondriasis but can also be present in other somatoform disorders, anxiety disorders, and mood disorders. In contrast to a dimensional view, the diagnosis of hypochondriasis represents a categorical view of HA. In the former DSM-IV (American Psychiatric Association, 1994), hypochondriasis is defined as a non-delusional preoccupation with fears of having, or the idea that one has, a serious disease based on misinterpretation of benign bodily symptoms. Additional criteria are persistence of the preoccupation despite appropriate medical evaluation and reassurance causing clinically significant distress and duration of at least 6 months. Similar diagnostic criteria are described in the ICD-10 (WHO, 1992). However, both the ICD and DSM diagnoses for hypochondriasis have been criticized for being too exclusive yet not preventing extensive diagnostic overlap with other somatoform disorders (Creed & Barsky, 2004; Fink et al., 2004; Gureje, Ustun, & Simon, 1997). In the new DSM-5 (American Psychiatric Association, 2013), hypochondriasis has been exchanged by two new diagnostic entities placed within the section of “Somatic symptom and related disorders,” that is somatic symptom disorder and illness anxiety disorder, respectively. The diagnoses share high HA as a criterion, but the presence of additional distressing somatic symptoms is also required for the former but not the latter diagnosis. A recent study showed that the majority of individuals originally diagnosed with DSM-IV hypochondriasis met the criteria for somatic symptom disorder (74%) rather than for illness anxiety disorder (26%) (Bailer et al., 2016), and the empirical evidence for this new classification is still lacking (Starcevic, 2013). It was recently critically evaluated by Rief and Martin, who concluded that pathological HA should better be classified as a unique condition distinct from other diagnoses within the category of somatic symptom and related disorders (Rief & Martin, 2014). Other researchers have suggested that hypochondriasis should be reclassified as an anxiety disorder (Olatunji, Deacon, & Abramowitz, 2009; Weck, Bleichhardt, Witthöft, & Hiller, 2011) due to the conceptual overlap with various types of anxiety disorders such as panic disorder, generalized anxiety, illness phobia, and obsessive-compulsive disorder.
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