The Big Book of Madness: the Vth Element is an expansion for The Big Book of Madness base game. Your goal remains the same: you must close the book before succumbing to madness. But will you be able to handle the new Dark Matter and Phobias?
The Dark Matter and the Phobias are two different modules that can be played together or separately.
The Dark Matter module adds the Vth Element and the following game elements: the Dark Book, Dark Curses, Dark Monsters and new Magicians.
Phobia Cards are Madness Cards with a permanent constraint.