Chapter 41: Somatic Symptom Disorder & Related Disorders
A patient presents with complaints of a left-handed tremor that results in tapping of her right hand. She also complains of frequent headaches and abdominal pain. After full examination, there is no evidence that suggests the symptoms are due to a medical or psychiatric condition. What would be the best diagnosis for her symptoms?
B. Illness anxiety disorder
C. Somatic symptom disorder
D. Body dysmorphic disorder
C. This patient has neurologic symptoms and other somatic complaints, such as abdominal pain, so the best choice would be somatic symptom disorder. If tremor were the only symptom and the nonneurologic symptoms were absent, conversion disorder would be the better answer.
Appropriate treatment for the patient described in Question 1 would include which of the following?
B. Cognitive-behavioral therapy (CBT)
D. CBT and antidepressants
E. Continued medical tests to rule out an organic cause
B. CBT has been shown to be most effective in treating somatic symptom and related disorders. The patient has no psychiatric symptoms, so antidepressants would not be the best choice for first-line treatment.
Mrs. H presents to her primary care physician with concerns that she may have a brain tumor. She indicates that she has a headache about once every 2 months, which she rates as a 2 out of 10 on the pain scale, and it subsides immediately when she takes ibuprofen. She has no other symptoms. She extensively tracks all of her headaches and brings the logs to each appointment. Her primary care physician runs several tests, all of which come back negative. She is referred to a neurologist who agrees with her doctor that she does not have a medical condition and that the occasional headaches are normal. However, Mrs. H returns to the doctor because she has been researching brain tumors on the Internet and is convinced her doctors have missed something. Mrs. H should be diagnosed with which of the following disorders?
B. Body dysmorphic disorder
C. Illness anxiety disorder
D. Somatic symptom disorder
C. Mrs. H is exhibiting significant preoccupation with having an illness, despite relevant symptoms being mild. She is ...