Comprehensive exams for Mental Health Q 145
An 83-year-old male client is in extended care facility is anxious most of the time and frequently complains of a number of vague symptoms that interfere with his ability to eat. These symptoms indicate which of the following disorders?
A. Conversion disorder
B. Hypochondriasis
C. Severe anxiety
D. Sublimation
Correct Answer: B. Hypochondriasis
Complaints of vague physical symptoms that have no apparent medical causes are characteristic of clients with hypochondriasis. In many cases, the GI system is affected. Hypochondriasis, which is now known as illness anxiety disorder, and the other somatic symptom disorders (e.g., factitious disorder, conversion disorder) are among the most difficult and most complex psychiatric disorders to treat in the general medical setting. On the basis of many new developments in this field, the DMS-5 has revised diagnostic criteria to facilitate clinical care and research. While illness anxiety disorder is included in the category of “somatic symptom and related disorders” it continues to have much overlap with obsessive-compulsive disorder and related illness.
Option A: Conversion disorders are characterized by one or more neurologic symptoms. Conversion disorder is a mental condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation. People who have conversion disorder are not making up their symptoms in order to obtain shelter, for example (malingering). They are also not intentionally injuring themselves or lying about their symptoms just to become a patient (factitious disorder). Some health care providers falsely believe that conversion disorder is not a real condition and may tell people that the problem is all in their head. But this condition is real. It causes distress and cannot be turned on and off at will.
Option C: The client’s symptoms don’t suggest severe anxiety. People with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).
Option D: A client experiencing sublimation channels maladaptive feelings or impulses into socially acceptable behavior. Transforming one’s anxiety or emotions into pursuits that are considered by societal or cultural norms to be more useful. This defense mechanism may be present in someone who channels their aggression and energy into playing sports.