Match each clinical presentation with the most appropriate psychiatric diagnosis.
- Sudden onset of unilateral blindness with completely normal ophthalmologic and neurologic exams after witnessing a traumatic accident.Conversion disorder (functional neurological symptom disorder)
- Excessive preoccupation with having pancreatic cancer for 8 months despite negative workups, with no active physical symptoms.Illness anxiety disorder
- Persistent, distressing abdominal pain and fatigue for over a year with excessive, disproportionate anxiety and time devoted to these symptoms despite negative medical evaluations.Somatic symptom disorder
- Surreptitious self-injection of insulin resulting in recurrent hypoglycemia (high insulin, low C-peptide), done to assume the sick role without obvious external reward.Factitious disorder imposed on self
Answer
The presentations match as follows: unilateral blindness with normal exams corresponds to Conversion disorder; preoccupation with pancreatic cancer without symptoms corresponds to Illness anxiety disorder; chronic abdominal pain and fatigue with excessive worry corresponds to Somatic symptom disorder; and surreptitious insulin injection to assume the sick role corresponds to Factitious disorder imposed on self.
Each clinical presentation uniquely aligns with the core diagnostic criteria of a specific disorder within the somatic symptom and related disorders spectrum. Correct identification relies on evaluating the presence and nature of somatic symptoms, whether symptoms are intentionally produced, and the underlying motivation (primary vs. secondary gain).
Step-by-Step Solution
Key Concept
Differentiation of somatic symptom and related disorders based on symptom presence, intentionality, and underlying motivation.