Somatic symptom and related disorder,

Dissociative DisorderPresented by

Raffia YosufMehak AneesM NazirFazia Shareef

Soma = body Somatic =relating to soma

Pathological concern with the appearance or functioning of the body usually in absence of any identifiable medical condition

Somatic symptom and related disorder

The diagnosis of somatic symptom disorders is historically rooted in the late 18th century diagnosis of "hysteria

In 1980 the APA replaced the diagnosis of hysteria in the DSM with more precisely defined conditions and symptoms, such as somatization disorder.

Criteria

Type Conversion disorderA psychological disorder having physical or neurological symptoms of a disease without physical or neurological evidence for that disease.

Illness Anxiety disorderPreoccupation with having or acquiring a serious illness but no somatic symptom

Fictitious disorderA form of mental illness where an individual will deliberately produce or exaggerate symptoms in order to gain sympathy and attention.

EnvironmentalFrequent with few

years of education and low socio economic status

Course ModifiersAssociated with

demographic features

TemperamentalPsychodynamic ViewCBT

Comorbidity

High Rates of Comorbidity with ; Anxiety Medical Disorders Depressive Disorders Irritable bowel syndrome Chronic pain Post-traumatic stress disorder Antisocial personality disorder History if sexual or physical abuse

Treatment or Interventions

Psychotherapy Exposure Psychiatric

consultation intervention (PCI)

Cognitive based therapy (CBT)

Behavioral techniques (relaxation training and mindfulness)

Medications

Dissociative Disorder The category of dissociative disorders includes a wide variety of

syndromes whose common core is an alteration in consciousness that affects memory and identity

Patients have lost sense of having one

consciousness

A continuum of disorders experienced

by individuals exposed to trauma, including

Derealization and Depersonalization disorder,

Dissociative amnesia,

Dissociative fugue

DSM I Classified as Psychoneurotic Disorders

DSM IIHysterical Neurosis and Dissociative Type

DSM III & III-RMultiple Personality DisorderDSM IV

Dissociative Identity Disorder (DID).

A. Disruption of identity characterized by two or more distinct personality states

B. Recurrent gaps in the recall of every day events, important personal information, and or traumatic events that are inconstant with ordinary forgetting.

C. the symptoms cause clinical significant distress

impairment in social, occupational, areas of functioning.D. The disturbance is not a

normal part of a broadly accepted cultural or

religious practiceE. The Symptoms are not attributable to the physiological of a substance.

Etiology

Psychodynamic view Caused by repression: people fight

off anxiety by unconsciously preventing painful memories, thoughts, or impulses from reaching awareness.

Behavioral View Grows from normal processes e.g.

forgetting Learned through operant

conditioning State-dependent learning (associated

with conditions under which it occurred)

Other Causes To cope with trauma.  In children to long-term physical,

sexual or emotional abuse. The stress of War, Natural disasters,

Accidents Dissociative Amnesia cause

Genetically (parents or close relations).

Disorders that are highly comorbid with dissociative disorders are

Personality disorders substance abuse disorder OCD Conversion Disorder Depressive disorders Somatic symptoms disorders Sleep disorders Eating disorders

Comorbidity

TreatmentPsychotherapies

Cognitive behavior therapy Hypnotic therapy Eye Movement

Desensitization and Reprocessing Therapy (EMDR)

Dialectical Behavior Therapy (DBT)

Medications Antidepressant Antianxiety Antipsychotic Injections of Barbiturates

e.g sodium amobarbital or sodium pentobarbital