Somatoform Disorders
Definition
Subjective Characterized by the presence of one or more physical symptoms accompanied by abnormal thoughts, feelings,
... [Show More] and behavioral reactions that cannot be defined by an underlying medical condition or disease.
Somatoform disorder
Highest Priority
Often undergo unnecessary surgeries, invasive diagnostic procedures, and drug trials, all of which can be life-threatening.
Somatoform Disorder
Secondary Gains
Somatization may be used for secondary gains such as attention and decreased responsibilities.
Hypochondriasis or Illness Anxiety Disorder
Definition
Preoccupied with having or eventually developing a serious illness.
May or may not present with somatic symptoms, and if they do, the symptoms are usually mild.
High level of anxiety and alarm about their health lasting at least 6 month.
May either excessively check for problems or avoid medical care.
Hypochondriasis
Signs and Symptoms
The most common symptoms are pain, gastric or intestinal distress, palpitations, dizziness, shortness of breath, sexual dysfunction, neurological symptoms, and fatigue.
Hypochondriasis
Nursing Interventions
Nurses role is to assess for any objective data and to explain the health complaints. Show concern, but avoid fostering dependency.
Conversion Disorder
Definition
Common Signs and Symptoms
Medical disorder (objective) that cannot be explained.
This disorder presents with one or more symptoms of impaired motor or sensory function. Findings are incompatible with or an exaggeration of recognized neurological conditions and are not better explained by another mental or medical disorder.
Most common are blindness, deafness, paralysis, inability to talk. Symptoms are beyond conscious control and are related directly to conflict .
Conversion Disorder
Nursing Interventions
Encourage independence in ADL's in a matter of fact manner.
Dissociative Disorders
Definition
A disturbance in the normally well-integrated continuum of consciousness, memory, identity, and perception.
Dissociation is an unconscious defense mechanism to protect the individual against overwhelming anxiety related to past trauma, and ranges from minor to severe in presentation.
Patients with dissociative disorders have intact reality testing, meaning they are not delusional or hallucinating.
Dissociative Fugue
The patient in a fugue state frequently relocates and assumes a new identity while not recalling previous identity or places previously inhabited.
The distracters are more consistent with paranoid schizophrenia, generalized anxiety disorder, or bipolar disorder. Head injury, posttraumatic stress disorder, or a neurological disorder should also be considered.
Dissociative Amnesia
Related to a traumatic incident, and may be accompanied by a fugue where the patient flees from their normal life to another location and starts a new life. Gradually over time, memories of the original life may be triggered. Patients can become confused and embarrassed when the amnesia subsides and memory returns.
Dissociative Identity Disorder
The most severe of the dissociative disorders. Disruption of identity by two or more distinct personality states. Involves discontinuity in the sense of self, accompanied by alterations in affect, behavior, memory, and functioning. Patients lose time, meaning they do not have memory of periods of time ranging from minutes to weeks.
The patient is often unaware of the other personalities. Each alternate personality has its own pattern of personality, perception, and memories.
Body Dysmorphic Disorder
Definition
A highly distressing and impairing disorder that ranges along the continuum from distressing to delusional severity.
They have preoccupation with an imagined defective body part; obsessional thinking, compulsive behaviors.
Individuals with BDD are frequently concerned with the face, skin, genitalia, thighs, hips, and hair.
Body Dysmorphic Disorder
Care Plan
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Body Dysmorphic Disorder
Highest priority
There is a high risk of completed suicide.
Personality Disorders
Definition
A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school.
Borderline Personality Disorder
Definition
Characteristics
A mental disorder characterized by unstable moods, behavior, and relationships.
Characteristics include emotional liability.
Instability in moods, interpersonal relationships, and high rates of self-injury.
Instability of affect.
Emotional instability
Poor Impulse control
Chronic Depression
Demonstrates a self-defeating cycle of behavior.
Borderline Nursing Interventions
Set limits, be consistent and assess your reactions toward patient.
Identify the needs and feelings preceding impulsive acts.
Teach or refer patient to appropriate place to learn needed coping skills.
Dialectical Behavior Therapy (DBT).
Histrionic Personality Disorder
Definition
Attention-Driven
Manipulating others through their dramatic, charming, flamboyant and sexual/seductive behaviors.
Meant to remain the center of attention.
Histrionic Disorder
Nursing Interventions
PsychoTherapy: Discussing the motivations and fears associated with their thoughts and behaviors.
Antisocial Personality Disorder
Description/Characteristics
Narcissistic
Deceit, manipulation, revenge and harm to other with an absence of remorse for hurting others.
They do not adhere to traditional values, morals, ethics, boundaries, and standards of society.
Obsessive Compulsive Disorder
Description
Difficulty expressing warm tender emotion, perfectionism, stubbornness, control issues, devotion to work.
Overly conscientious, inflexible, detail oriented (won't focus on anything else), exclude leisure time, miserable, hoarding, rituals. [Show Less]