Functional disorders
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Functional disorders manifest as physical discomfort without identifiable organic disease, affecting daily life and often linked to psychological causes. Symptoms can include headaches, fatigue, and various pains, with risk factors including stressful life events and potential genetic predisposition. Treatment options range from cognitive behavioral therapy to medication, aiming to improve patients' quality of life despite the challenges these disorders present.
Functional disorders
- 2. What is a functional disorder? • A functional disorder causes physical discomfort which makes everyday life difficult. It can be seen as a disorder where the mind and the body for various reasons are not functioning properly. • This term is used because the person has a disturbance of their functioning that arises in the absence of any disease.
- 3. Functional Symptoms vs. Organic Disease Functional Symptoms • No possible finding of organic or pathological tissue changes while physician investigating, psychological causes. • headaches, fatigue, insomnia, irritability, abdominal pain, indigestion, low back pain, or simply not feeling well. Organic symptoms • physical, cellular changes that can be identified by diagnostic testing • cancer, arthritis, heart disease, gastric ulcers, and emphysema.
- 4. Are functional disorders common? • Yes. Somewhere between 20% and 40% of people attending almost any hospital clinic have symptoms • sometimes disabilities for which there is no specific explanation. • The doctors cannot find evidence for any disease, or other damage to account for the symptoms.
- 5. Why is it called a ‘functional disorder’? • Many different names have been used. • the preferred name is "a functional disorder". • This term is used because the person has a disturbance of their functioning that arises in the absence of any disease. • The person’s function is disordered.
- 6. The following names have been used. • somatization, somatoform disorder • hysteria, hysterical disorder, conversion disorder • non-organic symptoms, non-organic illness, medically unexplained symptoms • stress-related symptoms, anxiety, atypical depression. • Many other names have been used.
- 7. Some examples of functional disorders are • Conversion disorder • Somatization disorder • Hypochondriasis • Body dysmorphic disorder • Pain disorder • Dissociative amnesia • Dissociative fugue • Depersonalization disorder • Dissociative identity disorder
- 8. Some risk factors for functional disorder. • a stressful childhood, with such things as abuse, being orphaned, and losing a parent • Experience of a severe unusual stress, such as exposure to a very nasty accident • Ongoing high stresses in life, such as an unsatisfactory job, problems at home, financial worries.
- 9. The common symptoms are: Symptoms from heart and lungs • Palpitations • Chest pain • Short of breath without exertion • Cold or hot sweats • Shaking or trembling • Mouth dryness • 'Butterflies' or abdominal churning Symptoms from stomach and intestines • Frequent loose stools • Abdominal pain • Bloated stomach • Abdominal tension or weight sensation • Diarrhea • Vomiting • Constipation • Nausea • Burning sensation in the chest or upper abdominal area
- 10. Con…… Symptoms from the muscles • Pain in the arms or legs • Muscular ache or pain • Pain in the joints (arthralgia) • Feeling of paresis or localized weakness • Backache • Pain moving from one place to another • Unpleasant numbness or tingling sensations General symptoms • Concentration difficulties • Fatigue • Headache • Impairment of memory • Dizziness
- 11. Among research scientists and practitioners there is a general consensus that: • the cause of functional disorders is multi-factorial, • the brain plays a part in a functional disorder. Scans have showed changes in the way the brain reacts when the body is inflicted with pain. • functional disorders are often caused by a combination of congenital vulnerability and strain and stress. • functional disorders can be treated with cognitive behavioural therapy and graded exercise therapy. Some patients will benefit from medicinal treatment, primarily from anti-depressant pills.
- 12. Con… • a functional disorder is a real disease. • the patients are not ‘pretending’ to be ill, and they are not patients who lie, cheat or exaggerate to gain social benefits. • Research shows that many patients can recover. Most of them can get a significantly better quality of life. However, some of them will have to keep showing consideration for their body and learn to live with the functional disorder, the same way that one can learn to live with other chronic diseases such as asthma or diabetes.
- 13. Functional disorders are challenging • Functional disorders challenge our usual way of thinking that an illness is either purely physical, psychological, social or something else. • To understand functional disorders it is necessary to look at the body, the mind and society as factors affecting each other and which all can be the cause of an illness.
- 14. Somatoform disorders & types • Subjective experience of many physical symptoms with no organic cause • Types • Conversion disorder • Somatization disorder • Hypochondriasis • Body dysmorphic disorder • Pain disorder
- 15. Conversion disorder Loss of functioning in the part of the body for psychological rather than the physical reason • Paralysis • Blindness • Mutism • Seizure • Hearing loss • Sever loss of coordination • Anesthesia in limb Somatization disorder Is a diagnoses when individuals have a history of numerous physical complains for which no medical causes can be found • Pain symptoms(Head , Back, Rectum, pain Legs) • Gastrointestinal(nausea, diarrhea) • Sexual disturbance • Neurological symptoms(paralysis, double vision, deafness)
- 16. Hypochondriasis Chronic worry that one has physical disease in the absence of evidence that one does and frequent seeking of medical attention • For example, that a minor headache may be caused by a brain tumour, or a mild rash is the start of skin cancer Body dysmorphic disorder Excessive preoccupation with the part of the body the person believes is defective • Headache • Pain in the back, muscles, joints • Stomach problems • Shortness of breath • Fatigue
- 17. Video of conversion and Body dysmorphic disorder
- 18. Pain disorder • Pain disorder is a condition where a person has a persistent pain that cannot be attributed to a physical disorder
- 19. Dissociative disorders • are conditions that involve disruptions or breakdowns of memory, awareness, identity, or perception. People with dissociative disorders use dissociation, a defense mechanism, pathologically and involuntarily. Dissociative disorders are thought to primarily be caused by psychological trauma. • Types • Dissociative amnesia • Dissociative fugue • Depersonalization disorder • Dissociative identity disorder
- 20. Dissociative identity disorder There are separate, multipule personalities in same individual. The personalities also may be aware of each other or may have amnesia for each other • Discontinuity in sense of self and sense of agency • Alteration in behavior consciousness, memory, perception, cognition, sensory motor function. • Recurrent gap in recall every day events, important personal information and traumatic events Dissociative amnesia Loss of memory for important facts about a person own life and personal identity • Amnesia can be psychogenic or organic
- 21. Dissociative fugue • Disorder in which a person moves away and assumes a new identity with amnesia for the pervious identity
- 22. Depersonalization disorder • The presence of persistence are recurrent experience of depersonalization, derealization or both • Depersonalization: experience of unreality, detachment or being an outside observer with respect to one thoughts, feelings, sensation, body, or actions for e.g perceptual alteration, distorted sense of time emotional or physical numbing, • Derealization: experience of unreality, detachment with respect to surroundings for e.g individuals or objects are experienced as unreal dream like foggy, life less, or visual distorted.
- 23. CAUSES No single cause several factors contribute • Some people are congenitally vulnerable.(genes) • Some people develop a functional disorder after great or long-term stress, e.g. (a divorce, illness in the family or social problems.) • Sometimes an infectious disease or an accident cause the development of a functional disorder.
- 24. HEREDITY Heredity is closely connected to functional disorders. • Genetic heredity • The probability is stronger among to develop a functional disorder in identical twins. • This probability is weaker among fraternal twins. • Social heredity • that stressful social circumstances may worsen a functional disorder. • Highly Complexity • You do not inherit a functional disorder the same way you inherit e.g. blue eyes or black hair. On the other hand. • if you experience one or several stressful events, you will have a stronger proneness to develop a functional disorder. • In certain families, Some people developed a functional disorder already in early childhood without the presence of any stressful events.
- 25. Role of Hormones • A state of alertness is caused by an activation of the so- called autonomic nervous system and the release of a large amount of stress hormones, e.g. cortisol and noradrenalin. • The stress hormones cause a production of a number of physical symptoms. • Many of the symptoms related to stress are the same symptoms we experience in connection with a functional disorder.
- 26. Treatment of Functional Disorder
- 27. Types Of Functional Disorder There are following two types Dissociative Disorder Somatoform Disorder
- 28. Method Of Treatment • Psychotherapy psychological methods to treat mental or emotional problems, eg to help patients to develop coping strategies. • Pharmacotherapy is therapy using pharmaceutical drugs
- 29. Psychotherapies • Psychodynamic Approach • Hypnotic Therapy • Group Therapy • Cognitive Behavior Therapy • Expressive Therapy • Behavior Therapy
- 30. Psychodynamic Approach • Psychodynamic therapists guide patients to their unconscious and bring forgotten experiences into consciousness • Psychoanalysts seek to help people with dissociative identity disorder uncover and learn to cope with early childhood traumas. They often recommend establishing direct contact with alter personalities (Burton & Lane, 2001).
- 31. Hypnotherapy • In hypnotic therapy, patients are hypnotized and guided to recall forgotten events • Therapist training in hypnosis is highly useful in the treatment of trauma and dissociation, especially DID. • It gives the therapist a broader awareness of the patient’s experiences as well as powerful techniques that can benefit the patient. • Formal induction is not usually needed on a regular basis.
- 32. Cognitive Behavior Therapy • A cognitive behavior therapy that incorporates mindfulness and a series of exercises to help the patient decrease trigger responses to internal and external stimuli. Helps with self-soothing. • distorted thoughts • unrealistic beliefs • behaviors that prompt health anxiety
- 33. Group therapy • DID in groups can be problematic. • Agreements need to be made about control of child alters during sessions. • Therapists have to be careful not to prematurely expose trauma to group. • Ongoing individual psychotherapy is needed to support the group process.
- 34. Expressive therapies • May be very useful to allow the patient to spill the feelings without the cognitive self- judgment that may accompany “talk therapy”.
- 35. Pharmacotherapy • Nearly all classes of psychotropic medications have been used empirically with DID patients. • Antidepressants: SSRIs treat depression/PTSD • Anxolytics: Short term for anxiety .
- 36. Pharmacotherapy • Neuroleptic/antipsychotics: Treat overactivation; thought disorganization; intrusive PTSD symptoms; chronic anxiety; insomnia; irritability • Opioid antagonist, naltrexone, decreases some depersonalization disorder symptoms
- 37. THANKS..