According to the aim of the Treaty of Rome from 1957 which postulated the free movement of workers throughout the European Union, the European Board of Psychiatry in the UEMS (European Union of Medical Specialists) carried out a comprehensive survey of training in psychiatry, including all member countries in order to evaluate the present state of training in psychiatry in each. The survey should indicate whether the training requirements [UEMS Section Psychiatry. Charter on training of medical specialists in the EU: requirements for the speciality psychiatry. European Archives of Psychiatry and Clinical Neuroscience 1997;247(Suppl.):S45-7; UEMS Section Psychiatry. Charter on training of medical specialists in the EU: requirements for the speciality psychiatry. ; 2003 [last revision]] have had an impact on the actual conditions of training in psychiatry in the member countries. We gathered 22 questionnaires from 31 national representatives involved and 424 questionnaires completed by the chief of training and the representative of trainees at the responding training centres from 22 countries. The results give an overview about the practice of training in psychiatry in many European countries. While there are great differences between the training centres in different countries, apparent progress towards developing high standards in training in psychiatry has been made.

This article describes the development of an outpatient concept for the day-clinic withdrawal treatment of alcohol dependent persons in a Hamburg institution for addiction aid. It reports the initial, selected results of a comparative follow-up study of patients discharged during the years 1998-2000, who either receive ambulatory treatment in the day clinic (n = 270) or inpatient treatment in the institution's special clinic (n = 462). Assessable questionnaires are available from 131 outpatients of the day-clinic treatment and 173 patients of the inpatient treatment form. The response rate - with reference to the group of those who were reachable - was 57.2 % for patients of the day clinic and 53.2 % for patients of the special clinic. The results of the study arrive at the conclusion that both treatment forms can be seen as thoroughly comparable with regard to primary outcome measurements (for example reduction of psychological stress, abstinence rates, reintegration into occupational life). Rehabilitants treated in the inpatient setting more frequently report that they had already contacted centres for further treatment and self-help groups during the rehabilitation phase, which however doesn't lead to a change of participation behaviour following the rehabilitation phase. This serves to confirm the assumption that an additional offer of a day-clinic service in the area of addiction rehabilitation provides a further, effective treatment concept that sensibly supplements the otherwise inpatient-oriented treatment landscape. The results indicate the quality of the work performed in the day clinic studied (as well as in the inpatient clinic) and should encourage the funding agencies and employees of other day clinic institutions in the field of addiction rehabilitation to participate in evaluation and quality assurance measures, thus continuing to bridge the gap between the (theoretical) state of knowledge concerning outpatient rehabilitation and the degree to which it can be successfully realized.

Fifty stroke patients who had already regained basic ADL-functions were investigated at the beginning and end of either inpatient or outpatient rehabilitation of similar therapeutic intensity in the same institution. For geographic reasons, outpatient treatment could only be offered to a subgroup of patients. Neurological deficits, extended ADL-functions and quality of life (SF-36) were assessed. Patients who chose outpatient rehabilitation exhibited milder neurological deficits and better ADL-function at onset. On average, outpatient rehabilitation took about 8 days more than inpatient treatment. Under rehabilitation, gains with respect to ADL-functions and the QoL-dimensions "physical role function" and "physical functional ability" were realized. The magnitude of changes did not depend on setting. A decrease in "general health perception" may be related to the inpatient treatment of patients who would have preferred an outpatient setting. Brief periods between stroke and onset of rehabilitation and longer duration of rehabilitation treatment were significantly associated with better outcome with respect to ADL-functions.

Die erste deutschsprachige evidenz- und konsensbasierte S3-Leitlinie zur Diagnostik und Therapie der Zwangsst?rungen verfolgt das Ziel, die Versorgung der betroffenen Patienten zu verbessern und die Entscheidungsgrundlage f?r die Berufsgruppen zu optimieren, die an der Behandlung und Betreuung von Personen mit Zwangs?st?rungen beteiligt sind. Sie umfasst nicht nur Empfehlungen zur Diagnostik und Therapie, sondern soll diese auch f?r Betroffene und ihre ?Angeh?rigen transparent machen, um ihnen eine weitgehend selbstbestimmte Beteiligung am Behandlungsprozess zu erm?glichen.

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