Somatic Symptom and Related Disorders: Fundamentals of Psychological Disorders

Module Overview

• Focus: Somatic symptom disorders, including clinical presentation, epidemiology, comorbidity, etiology, and treatment options.
• Disorders discussed: Somatic symptom disorder, illness anxiety disorder, functional neurological symptom (conversion) disorder, and factitious disorder.
• Psychological factors affecting medical conditions.

Module Outline

1. Clinical Presentation
2. Epidemiology
3. Comorbidity
4. Etiology
5. Treatment
6. Psychological Factors Affecting Other Medical Conditions

Module Learning Outcomes

• Description of clinical presentations, epidemiology, comorbidity, etiology, and treatment options for somatic symptom disorders.
• Understanding of psychological factors affecting medical conditions.

8.1 Clinical Presentation

Learning Objectives

• Describe somatic symptom and related disorders.
• Presentation of specific disorders: Somatic symptom disorder, illness anxiety disorder, functional neurological symptom disorder, factitious disorder.

Disorders Overview

• Somatic Symptom Disorder: Multiple significant somatic symptoms affecting daily life. Symptoms may be localized or diffused, specific or nonspecific.
• Illness Anxiety Disorder: Excessive preoccupation with having/acquiring a serious illness without the presence of significant somatic symptoms.
• Functional Neurological Symptom Disorder: Symptoms of altered voluntary motor/sensory function, not explained by a medical disorder.
• Factitious Disorder: Deliberate falsification of symptoms for deception, affecting oneself or others.

Key Takeaways

• Somatic symptom disorder impacts daily functioning with multiple symptoms.
• Illness anxiety disorder focuses on acquiring illness rather than symptoms.
• Functional neurological disorder involves motor/sensory function alterations.
• Factitious disorder involves deliberate symptom falsification.

8.2 Epidemiology

Learning Objectives

• Describe the prevalence of somatic disorders.

Prevalence

• Somatic symptom disorder: 4-6%, more common in females.
• Illness anxiety disorder: 1.3% to 10%, equal in males and females.
• Factitious disorder and functional neurological disorder: Prevalence largely unknown.

Key Takeaways

• Prevalence rates vary, with 1-10% of the population affected.
• Gender differences noted, particularly in somatic symptom disorder.

8.3 Comorbidity

Learning Objectives

• Describe comorbidity of somatic disorders.

Comorbidity Details

• High comorbidity with anxiety and depression.
• Illness anxiety disorder often co-occurs with OCD and personality disorders.
• Functional neurological disorder linked with personality disorders.
• Central sensitivity syndromes also highly comorbid.

Key Takeaways

• Common comorbidities include anxiety, depression, PTSD, OCD.
• High overlap with central sensitivity syndromes.

8.4 Etiology

Learning Objectives

• Understanding causes of somatic disorders.

Etiological Perspectives

• Psychodynamic: Somatic symptoms as responses to unconscious emotional issues.
• Cognitive: Result of negative beliefs or exaggerated fears about sensations.
• Behavioral: Developed/maintained by reinforcers such as attention.
• Sociocultural: Influences from family and culture.

Key Takeaways

• Etiology involves multiple perspectives: psychodynamic, cognitive, behavioral, sociocultural.

8.5 Treatment

Learning Objectives

• Describe treatment options for somatic disorders.

Treatment Options

• Biopsychosocial Model: Considers biological, psychological, and social factors.
  • Psychotherapy: Includes interpersonal psychotherapy, CBT, behavioral therapy.
  • Psychopharmacology: Rarely used; focuses on comorbid disorders.

Key Takeaways

• Biopsychosocial model is effective, involving multidisciplinary approaches.
• Limited use of psychopharmacology due to side effects.

8.6 Psychological Factors Affecting Other Medical Conditions

Learning Objectives

• Description of psychological factors affecting medical conditions.

Psychophysiological Disorders

• Common types: Headaches, gastrointestinal issues, insomnia, cardiovascular disorders.
• Treatments include relaxation training, biofeedback, hypnosis, CBT, group therapy.

Key Takeaways

• Focus on physical disorder impacted by psychological factors.
• Treatments target both psychological and physical symptoms.

Module Recap

• Comprehensive overview of somatic disorders and their treatment.
• Discussion of psychological factors affecting medical conditions.