Evaluate the concise patient vignettes below and link each to the most accurate DSM-5 psychiatric classification.
- A young adult with a normal BMI reports weekly episodes of consuming unusually large quantities of food with a sense of lost control, followed by self-directed laxative use.Bulimia nervosa
- An adult with persistent, diffuse joint aches and abdominal discomfort who devotes several hours daily to researching the symptoms, resulting in significant functional impairment.Somatic symptom disorder
- A healthcare worker presenting with recurrent polymicrobial bacteremia, subsequently found to have concealed syringes of contaminated material in their hospital room belongings.Factitious disorder
- An adolescent developing abrupt, bilateral lower extremity paralysis immediately following a severe psychosocial stressor, with intact reflexes and completely normal neuroimaging.Functional neurological symptom disorder
- A middle-aged adult who repeatedly requests advanced imaging, convinced they harbor a malignant tumor despite lacking any significant physical symptoms or abnormal laboratory findings.Illness anxiety disorder
Cevap
Vignette 1 matches Bulimia nervosa; Vignette 2 matches Somatic symptom disorder; Vignette 3 matches Factitious disorder; Vignette 4 matches Functional neurological symptom disorder; Vignette 5 matches Illness anxiety disorder.
Each vignette contains distinct, diagnostic features according to DSM-5 criteria: binge/purge cycles at normal weight (Bulimia), significant physical symptoms with excessive worry (Somatic Symptom), fear of disease without physical symptoms (Illness Anxiety), intentional disease simulation for primary gain (Factitious), and incompatible neurological signs (Functional Neurological).
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Anahtar Kavram
Accurate differentiation of the somatic symptom spectrum relies on identifying the primary driver: actual symptoms causing distress, fear of disease without symptoms, intentional deception for sick role, or incompatible neurological deficits.