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Old 05-10-2011
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Psyche USMLE Step 1 Psychiatric Diagnosis?

A 27 year old woman comes to the clinic because of a 7 year history of intermittent headaches, abdominal pain and bloating, low back pain, diarrhea, pain during intercourse, deceased interest in sex, and difficulty with balance. She tells the physician that she is frustrated because she cannot work because of her symptoms. She has seen 12 physicians in the past 5 years, none of whom has been able to diagnose her condition. This patient most likely has which of the following?

a. Autoimmune vasculitis
b. Chronic cadmium toxicity
c. Factitious disorder
d. Fibromyalgia
e. Paraneoplastic syndrome
f. Somatization disorder
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Old 05-10-2011
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Somatisation disorder F
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Old 05-10-2011
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agree its F.

Somatization disorder
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Old 05-10-2011
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I thought it was fibromyalgia... I feel like with a somatization disorder a patient would have been diagnosed earlier because you can SEE the problem. With fibromyalgia it's common to go undiagnosed for years because there's no "real" problem. Guess I'm wrong
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Old 05-10-2011
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Somatization has to have symptoms about pain, git & sexual problems for diagnosis.

If u keep that in mind, its not a hard diagnosis to make.
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Old 05-10-2011
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Actually, with somatization you don't see the problem, and that's why it's a difficult diagnosis to make. A general way to figure out it's somatization is to look for 4 pain symptoms, 2 GI, 1 sexual, and 1 neurologic. This question fits that perfectly- 4 pain, diarrhea/bloating, decreased interest in sex, difficulty with balance.
Fibromyalgia is primarily a pain syndrome with multiple areas of muscle pain. It wouldn't explain the GI symptoms, neurological symptoms, or the sexual issues.
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ans-f somatization disorder
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Old 05-10-2011
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f.. somatization disorder .. I have seen a similar patient and U never like the expression of such a patient bcz the investigations always ditch the symptoms and he/she believes u may be incompetent
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