The aim of the study was to test whether the routine use of the Hospital Anxiety and Depression Scale HADS changes the frequency and the duration of calling the psychosomatic C-service. 70% of all patients of the department of cardiology/pneumology were registered by the HADS. Psychometric screening raised the number of patients checked by the C-service (15.3 vs. 2.7% of all patients of the department; p < 0.01) and reduced the duration of the call for the C-service (2.7 vs. 6.4 days; p < 0.01) compared to conventional C-service. Elevated scores in HADS were found in 26% of the patients (21% depression, 12% anxiety).

The effects of a dynamically oriented therapy on three patients with functional complaints were followed up by means of clinical judgement and by means of the repertory grid technique (G. Kelly). Special emphasis was laid upon the assessment of hostile attitudes which the patient connects with self, doctor and an imaginative ideal partner. It was assessed how he relates himself to therapist and ideal partner. Finally clinical judgement and grid results were compared. There is a denial of the existence of hostility in self, doctor, partner at the beginning as well as during treatment. There is a trend towards a reduction of the initial idealization of self and therapist. In the individual case significant changing scores can be demonstrated which correspond to the therapeutical course. Thus the grid may be used for supervision purpose in therapy.

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