SITI AMALINA BINTI AWANG

CASE VIGNETTE

Somatic Symptom Disorder

Mrs A, 45 years old, malay, female, complaining of having chest pain and palpitations for the past 2 years.
She saw multiple doctors and having frequent visits to Emergency Department for investigations. She was
referred to medical department and was seen by specialist but all the assessment was normal. She feel very
stressful and worry about the chest pain and palpitations despite of reassurance that there is no evidence that
she was having any medical problem. These conditions has affected her daily functions and she was unable
to work as a clerk properly.

Illness Anxiety Disorder

Mr B, 32 years old, malay, male claimed that he colon cancer for the past 1 year. This issue started after his
father died of colon cancer. Over the past 1 year, he saw multiple doctors and oncologists and requested for
multiple investigations. However through history, physical examination and investigations, there is no evi -
dence of him having colon cancer but he insisted that he had colon cancer regardless of the results.

Conversion Disorder
Mr C, 38 years, malay, male, work was an army officer suddenly complain of right body weakness. Patient
was brought to emergency department. Noted that during physical examinations, there is no neurological
deficit. Blood investigations and CT brain were done to rule out for any medical causes of right body weak-
ness however the results are unremarkable.

Psychological Factors Affecting Medical Condition

Mrs D, 40 years old, malay, female had underlying bronchial asthma under medical follow up. Her asthma
attacks usually comes about 2-3 times per year and didn’t require any admission. However, since the past 6
months, she had been admitted to medical ward every month for moderate to severe asthma attack and re-
quire ICU admissions. On further history, she had been having anxiety symptoms for the past 6 months as
she worry about COVID 19.

Body Dysmorphic Disorder

Miss E, 18 years old, female believed that she was so ugly that she need plastic surgery. This belief started
after she had serious acne problem over her face since 1 year ago. Since then, she was preoccupied with her
appearance and feel very conscious about others opinion on her appearance. She will frequently wash her
face, checking herself over the mirror and compare herself to others. Her study performance and social life
was affected since then.

Factitious Disorder
Mr F, 35 years old, male, claims that he has episodes of seizures because of epilepsy. He had been admitted
to the ward for multiple times and seem to be happy during the admission. He will refuse to be discharge de -
spite of being free of seizure episode. On further investigations, noted that patient had insulin injection that
he used to induced seizure secondary to hypoglycaemia.

Other Specified/Unspecified Somatic Symptoms and Related Disorder

Mrs G, 45 years old, female, had been having chest pain for the past 3 months. She had no known medical
illness. She went to clinic and hospital to seek for treatment but the physical examinations and investigations
are unremarkable.