What Kind of Patients Receive Inpatient and Day-Hospital Treatment in Departments of Psychosomatic Medicine and Psychotherapy in Germany?

Abstract

<b><i>Introduction:</i></b> Germany is one of the few countries with a medical specialty of psychosomatic medicine and psychotherapy and many treatment resources of this kind. <b><i>Objective:</i></b> This observational study describes the psychosomatic treatment programs as well as a large sample of day-hospital and inpatients in great detail using structured diagnostic interviews. <b><i>Methods:</i></b> Mental disorders were diagnosed according to ICD-10 and DSM-IV by means of Mini-DIPS and SCID-II. In addition to the case records, a modified version of the CSSRI was employed to collect demographic data and service use. The PHQ-D was used to assess depression, anxiety, and somatization. <b><i>Results:</i></b> 2,094 patients from 19 departments participated in the study after giving informed consent. The sample consisted of a high proportion of “complex patients” with high comorbidity of mental and somatic diseases, severe psychopathology, and considerable social and occupational dysfunction including more than 50 days of sick leave per year in half of the sample. The most frequent diagnoses were depression, somatoform and anxiety disorders, eating disorders, personality disorders, and somato-psychic conditions. <b><i>Conclusions:</i></b> Inpatient and day-hospital treatment in German university departments of psychosomatic medicine and psychotherapy is an intensive multimodal treatment for complex patients with high comorbidity and social as well as occupational dysfunction.

The multicenter effectiveness study of inpatient and day hospital treatment in departments of psychosomatic medicine and psychotherapy in Germany

“…At least one diagnosis of a concurrent somatic disorder occurred in 1,363 (65.1%) of the patients. More detailed information about diagnoses is given in Doering et al ( 21 ).…”

“…A detailed description of the patient sample (n = 2,094) at baseline has already been published [21]. The patient flow chart is provided in Figure 1.…”

“…At least one diagnosis of a concurrent somatic disorder occurred in 1,363 (65.1%) of the patients. More detailed information about diagnoses is given in Doering et al (21). that had shown a moderate or severe psychopathology at baseline yielded clinically significant improvement at discharge in those outcome domains (Table 1).…”

Psychosomatic Disorders Issue: A Lecture

“…Возможна примесь слизи к фекалиям или даже выделение ее в виде клочьев, пленок. Иногда наблюдается проктомиксорея -приступообразное выделение слизи из прямой кишки [3,12,17,20,25].…”

Implementing the Biopsychosocial Model in Clinical Medicine: A Tribute to Giovanni Fava

“…However, findings are restricted to naturalistic studies as the design of RCTs is impaired by methodological, pragmatic, and ethical reasons [38]. A prospective naturalistic study was initiated at 19 German university hospitals for psychosomatic medicine and psychotherapy, which included a total of 2,094 patients and is currently in final evaluation [39]. A previous systemic review and meta-analysis including 59 studies on inpatient treatment reported a medium within-group effect size for symptom change of d = 72.…”