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Somatic symptom disorder and other disorders

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Arshya Vahabzadeh.

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Video transcript

- [Narrator] We know that medical conditions often result in physical symptoms. We also realize that mental disorders, disorders affecting the mind, such as depression, schizophrenia, anxiety disorders, they can result in psychological symptoms. We should also realize that medical conditions can in fact, also manifest in psychological symptoms. Whether we look at autoimmune conditions or we look at cardiovascular disease or diabetes, people with those conditions can get symptoms of depression, symptoms of anxiety, and even full blown psychiatric/mental disorders, so we should also bear that in mind. By the very same token, Mental disorders can also manifest in physical symptoms. Part of that could be, for example, depression can manifest in disturbances of sleep, but I want you to really concentrate on this, because for some mental disorders, this becomes a really big deal and manifests in a really big way as physical symptoms either directly leading to physical symptoms or exacerbating physical symptoms that may already be occurring from medical conditions and may already be present. I'm going to talk about a couple of those now. The first one I want to talk about is something called Somatic Symptom Disorder, and I actually want to compare that to another disorder called Conversion Disorder. Now when I say somatic, what I'm actually referring to is physical symptoms, so if we go back to our boxes up here, when I said "physical symptoms," when we talk about how mental disorders manifest, this is just another word for somatic, and somatic is another word for physical. You can think of this as Physical Symptom Disorder in some ways. The first thing I want to do is to talk about what kind of symptoms can arise, and in Somatic Symptom Disorder, we can have any symptom. It could be something very, very specific like wrist pain, or it could be something much more generalized like a general feeling of fatigue. It could be any symptom whatsoever. Now contrast this to what we have in Conversion Disorder, because in Conversion Disorder, we're actually looking for something that's very neurological. Think about it as a problem with speech, with swallowing, with seizures, or even with paralysis, anything whatsoever that could be a neurological symptom that looks like, I should say, a neurological symptom. Now the second point I'm going to say, when we think about Somatic Symptom Disorder, we may or may not be able to explain what we see these symptoms with medical tests. What this means is that they may or may not be related to a medical condition. Conversion Disorder on the other hand, is very, very different. The neurological symptoms that we see are incompatible with any known neurological or medical condition. We simply cannot explain them based on our tests or clinical exam. What makes Somatic Symptom Disorder a mental disorder? Well, when we say "disorder," we're looking at some functional impairment. This condition stops people from doing things that they like to do. It stops them from say, going to school, enjoying life, and how does it do that? It does that in a variety of ways. These individuals, when they have these symptoms, really get stressed out. They really get worried, and they get worried very, very excessively. They can have really extreme levels of anxiety, and they can spend a lot of time and energy worrying and thinking about their symptoms. All of these things are to a totally excessive level. Excess, totally excessive level, and it's really impairing for them, the level of worry, anxiety, and the amount of time and resources they spend worrying about these, stressing about these symptoms. Now when we look at Conversion Disorder, we have these neurological symptoms that cannot be explained by our understanding of medicine or neurology, but it's something that we sometimes can see, not always, but sometimes can see when we talk to these individuals and we try and understand them is that they sometimes have a level of psychological stress or traumatic event that's happened to them, and the stressor or trauma can actually be resulting in this manifestation of these neurologic symptoms. Finally, there's another condition I want to touch base on, and that condition is called Factitious Disorder. Now in this disorder, the patient wants to be "sick," and they will falsify or deceive their physical signs and symptoms in order to get a diagnosis and treatment. They may injure themselves. They may falsify tests. You may have heard of this as Munchhausen's or even Munchhausen's by proxy. Munchhausen's by proxy is a Factitious Disorder of another individual. One person is actually trying to make another person look ill, so that there's medical attention, investigation, treatment provided for another individual. What's notable about Factitious Disorder is that people aren't doing this for money, and people are doing this very specifically to be in this "sick" role.