New book by UBC neuropsychiatrists aims to draw attention to modern medicine's "elephant in the room"

An elephant walking into a spotlight in a dark room.

Understanding and Managing Somatoform Disorders - A Guide For Clinicians is a new book by Drs. Anton Scamvougeras and Andrew Howard, Clinical Associate Professors in the Department of Psychiatry at UBC and clinicians in the BC Neuropsychiatry Program. The text offers insight into a very common yet poorly understood class of conditions that occur when emotional distress manifests physically, and provides a thorough approach to somatoform disorder assessment and treatment.

The authors indicate that 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 symptoms associated with somatoform disorders, yet these conditions most often remain unidentified and misunderstood.

Somatoform disorders present with long-lasting, unexplained physical symptoms in multiple systems in the body. These symptoms can include pain, stomach and bowel trouble, urinary difficulties, and various nervous system problems including paralysis, non-epileptic seizures and gait disturbances. In many individuals somatoform mechanisms may result in diagnoses such as Fibromyalgia, Chronic Fatigue Syndrome, or Irritable Bowel Syndrome. While only the most severe somatoform disorders are life-threatening, they often profoundly affect a person’s quality of life. The physical presentation masks underlying psychiatric concerns including depression and anxiety, and leads to unnecessary investigations and treatments, which may be potentially harmful.

Somatoform disorders raise important questions about the way in which emotional suffering is experienced and expressed in our communities, the authors report. People will very often seek medical attention for emotional distress not via direct psychiatric complaints but rather indirectly, through somatoform symptoms. Because these symptoms are not immediately identifiable as psychiatric in nature, these patients are most often not identified as being emotionally distressed, and their underlying suffering goes unidentified, unaddressed, and untreated.

The authors hope that this book will serve as a valuable resource for clinicians in general and psychiatric practice. The purpose of the new publication is to share a clear, comprehensive and effective approach to understanding, assessing and treating individuals with these common conditions, and to encourage more clinicians to work in helping this population.

Understanding and Managing Somatoform Disorders – A Guide For Clinicians (Scamvougeras & Howard 2018) is available online