Somatoform disorders: severe psychiatric illnesses neglected by psychiatrists

BASS, CHRISTOPHER
PEVELER, ROBERT
HOUSE, ALLAN

CHRISTOPHER BASS, Department of Psychological Medicine, John Radcliffe Hospital, Oxford; ROBERT PEVELER, Royal South Hants Hospital, Southampton; ALLAN HOUSE, Division of Psychiatry and Behavioural Sciences, University of Leeds, Leeds

Correspondence: C. Bass, Department of Psychological Medicine, John Radcliffe Hospital, Oxford OX3 9DU. Tel: 01865 220379; Fax: 01865 220373

(First received 21 August 2000, final revision 13 February 2001, accepted 13 February 2001)

British Journal of Psychiatry 179:p 11-14, July 2001.

Background

Somatoform disorders have few peers in terms of personal morbidity and cost to the health service, yet many psychiatrists train without any experience of them.

Aims

To review the prevalence, disability and economic burden of somatoform disorders, and to explore the reasons why they are neglected by psychiatrists.

Method

A selective review of the key literature.

Results

Psychiatrists' current preoccupation with so-called 'serious mental illness' gives somatoform disorders low priority. Some health planners have erroneously equated severity with diagnosis rather than level of need and disability. As a consequence the development of psychiatric services has been neglected.

Conclusions

Greater recognition of the importance of somatoform disorders will only occur if high quality research and teaching receive priority, and if the Royal Colleges continue to press for increasing public awareness of their importance. Services should be driven by clinical need rather than diagnosis.

Declaration of interest

None.