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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10584
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I'm an Australian OBGYN of 30 years standing, My scepticism

Customer Question

I'm an Australian OBGYN of 30 years standing, My scepticism overcame me yesterday when I was presented with a 19 yr old 24 weeks pregnant who claimed to have this condition but could not provide any evidence to confirm the diagnosis. Is there anything in the DSM about psychiatric components of this "disorder" Could it be what used to be known as hysterical conversion reaction or similar? Seems to be a classic case of "I have a rare disorder that no one knows about and I'm going to get as much secondary gain out of it as possible", Any thoughts
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for using JustAnswer. I think part of your question may have been cut off, what disorder or condition are you specifically talking about?

Customer: replied 1 year ago.
Exercise induced anaphylaxis
Expert:  Dr. Z replied 1 year ago.

Exercise induced anaphylaxis is a true disorder, but it is not listed as a psychiatric disorder at all. It is possible that this disorder could be a Conversion or Somatic Disorder, but it would be near impossible to do it for secondary gain as that would indicate that the person purposefully caused the symptoms of Pruritus, Urticaria, Angioedema, and Shortness of Breath for a secondary purpose (e.g. attention, financial gain, etc...). Somatic and Conversion disorders are physical and neurological symptoms caused by psychological distress, but it is not purposeful or for secondary gain. As of right now though Exercise induced anaphylaxis is considered a rare and non-psychiatric disorder. So at this point there is nothing to suggest that the disorder Exercise induced anaphylaxis should be in the DSM-5 based on current research, but that does not mean that this could not change for the future.

Expert:  Dr. Z replied 1 year ago.

I hope this answers your question and gives you some guidance on this issue. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.

*Please do not forget to leave a positive rating at the top of the page so that I can get credit for helping you. Thank you, ***** ***** appreciate it.

Customer: replied 1 year ago.
I remain highly sceptical given the aetiology of true anaphylaxis. I suspect they inhale something that provokes it rather than caused by exercise directly. There needs to be a trigger protein.
Expert:  Dr. Z replied 1 year ago.

If the individual purposefully inhaled something to cause the anaphylaxis then it would be considered a Factitious Disorder, much like Munchausen's Disorder, and that would fit the psychiatric model. If the anaphylaxis was caused by something else in the air, ingested (e.g. supplements not meant to purposefully cause this), etc... than there would be another medical cause that should be explored. I agree it is a rare disorder and not many cases have been "verified" in the literature, but that does not mean it is not possible. This patient should have gone through an extensive battery of tests to rule out more common causes before a physician settled on this diagnosis.

Expert:  Dr. Z replied 1 year ago.

I hope this answers your questions and gives you some guidance on this issue. Please let me know if you have any questions or concerns as I am happy to assist and support you regarding this issue.

*Please do not forget to leave a positive rating at the top of the page so that I can get credit for helping you. Thank you, ***** ***** appreciate it.