Understanding and Managing Somatoform Disorders - A Guide For Clinicians

Somatoform Disorders occur when emotional distress is unconsciously and involuntarily expressed in the form of symptoms and signs of physical illness. The clinical features cannot be explained by general medical causes and no underlying physical pathology exists. Many individuals disabled by common chronic conditions such as Fibromyalgia, Chronic Fatigue Syndrome, Irritable Bowel Syndrome, and other well-known syndromes, are suffering Somatoform Disorders under different names. Somatoform Disorders represent the 'Elephant in the Room' for modern medicine. One in every five individuals seeking medical care anywhere in the world is doing so because they have a Somatoform Disorder, yet these conditions most often remain unidentified and misunderstood. As a result they go untreated and a large burden of suffering is unaddressed. Once Somatoform Disorders are understood for what they are, treatment can be effectively directed. Often longstanding and seemingly untreatable these conditions do improve with straightforward therapeutic approaches, the components of which are already available in most communities. This text, authored by two physicians who work in a team that specializes in helping individuals suffering these conditions, offers an understanding of these complex syndromes and a thorough approach to their assessment and treatment. Clinical vignettes and specific suggestions give the reader the experience of accompanying the team as it works to understand and help these patients. Emphasis is placed on customizing the treatment to suit not just the needs of the patient, but also the strengths and skills of the treating clinician. The authors encourage other clinicians to join them in this essential, challenging, and professionally gratifying work. Anton Scamvougeras MBChB FRCPC and Andrew Howard MD FRCPC are Consultant Neuropsychiatrists in the University of British Columbia Neuropsychiatry Program, Vancouver, BC, Canada.