Abstract
Keynote Speaker: Kirmayer L
Commentary: Invited Multidisciplinary Expert Panel Compensable injury results in chronic pain and serious disability and impairment in about 5–10% of cases. In these cases, psychiatrists are often consulted from a medico-legal perspective to comment on psycho-social issues, psychiatric illness and management.
Assessment and management of these patients is difficult because of the many complex issues and contingencies which operate to contribute to the chronicity, morbidity and impairment. Somatisation is present almost invariably in each of these patients.
Objectives: The workshop aims to achieve the following:
to review recent work on somatisation
to present a framework for understanding somatisation in work related chronic pain disorders
to present a framework for the management of somatisation in these patients
to receive feedback from the panel –
Method: The workshop will be divided into 3 sections: a case of chronic, compensable back pain will be presented, reviewed at the start of the workshop; comment and input will be provided by the panel and Prof. Kirmayer followed by the presentation of a theoretical framework by Drs Pols and Battersby followed by discussion and then thirdly the case will be reassessed by participants. Participants will have available a handbook to assist with the workshop process.
Discussion: The basis of the workshop will revolve around the case presentation. Reflections on the case will allow commentary by the expert multi-disciplinary panel. The recent literature on somatisation will be reviewed by Professor Kirmayer. A framework for understanding of the somatisation process and a practical “containment” algorithm will be described. Such an approach has been shown to be effective empirically and in the recently completed somatisation project. It is also a useful model for psychiatrists to use in consultation liaison practice to support general practitioners, pain units, staff and clinicians working in the rehabilitation area.