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Somatic Symptom and Related Disorders, Factitious Illness, and Malingering in the Oncology Setting 

Somatic Symptom and Related Disorders, Factitious Illness, and Malingering in the Oncology Setting
Chapter:
Somatic Symptom and Related Disorders, Factitious Illness, and Malingering in the Oncology Setting
Source:
Psycho-Oncology (3 ed.)
Author(s):

Ted Avi Gerstenblith

, Lucy E. Hutner

, Felicia A. Smith

, and Theodore A. Stern

DOI:
10.1093/med/9780199363315.003.0043

Patients with medically unexplained symptoms often experience significant distress and impaired functioning; such symptoms may lead to a diagnosis of a somatic symptom and related disorder. Psychiatrists who work in oncology settings are likely to evaluate patients with somatic symptom and related disorders because these conditions are common. By contrast, conversion disorder often involves a loss or change in sensory or motor function that suggests a physical disorder, but lacks evidence of a medical or neurological condition. Those with factitious illness and malingering deliberately fabricate or feign symptoms to occupy the sick role (primary gain) or to obtain material reward (secondary gain), such as disability payments. Treatment includes ruling out medical emergencies, offering psychiatric assistance, setting clear boundaries, thoroughly documenting the assessment and treatment, and managing countertransference reactions elicited by the patient.

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