A 36-year-old woman presents with headache, backache, epigastric fullness, and decreased sexual desire. She has lost -2.5 kg over the past 3 years, and her appetite is otherwise normal. Her husband had a major vehicular accident 8 years back. Which of the following diagnoses best describes the mental status of this patient?
Ans. c (Somatization disorder), (Ref. Psychiatry by Niraj Ahuja 7th ed. 125, 197)SOMATIZATION DISORDERA history of many physical complaints beginning before age 30 years that occur over a period of several years and result in treatment being sought or significant impairment in social, occupational, or other important areas of functioning. Each of the following criteria must have been met, with individual symptoms occurring at any time during the course of the disturbance:1. Four pain symptoms2. Two gastrointestinal symptoms3. One sexual symptom4. One pseudoneurologic symptom. All the symptoms are not intentionally produced or feigned.Post traumatic stress disorder (PTSD)Delayed and protracted response to an exceptionally stressful or catastrophic situation or life event which causes pervasive distress in almost any person (e.g. natural calamities/disasters, wars, rape, torture or serious accident). It is characterized by recurrent and intrusive recollections of stressful event either in flashbacks or dreams. Associated sense of experiencing of stressful event with anxiety and increased arousal. Partial amnesia, feeling of numbness and anhedonia.Depersonalization disorderIt is a dissociative disorder, diagnosed when patients report feeling detached from their mental processes or body (e.g. feelings as if they are in dream), however patient accurately report who they are and what is going around them, but it results in significant distress or impairment in functioning.DepressionThe diagnosis of depression should be considered in any geriatric patient who complains about increasing levels of somatic concern. An important point is that although many patients and clinicians believe that depression is a normal feature of a terminal illness, most terminally ill patients do not become depressed.
Depersonalization disorder
Adjustment disorder and depression
Somatization disorder
Posttraumatic stress disorder (PTSD)
Somatoform Disorders