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At least 19 recordsLinked to original sources
PubMed1983

Psychosomatic education in West Germany.

Psychosomatic medicine (PsM) is taught to nearly all of the 12,000 West German medical students. It has become part of the curriculum by legal act (1972) and now forms part of the national syllabus. There are independent university departments in PsM at approximately three-quarters of the 27 medical schools in West Germany. In approximately two-thirds of the medical schools PsM is taught by members of departments lacking close working links with departments of non-psychiatric health services. The topic of liaison psychiatry is virtually excluded from the national syllabus. In teaching sessions, patients with psychogenic disorders predominate, which may bias the attitudes of students. The overall reception of PsM by students is fair to good although their expectations must be dealt with carefully. Many complain that the teaching in this subject is too short. Some of them (20-30%) can be motivated to join electives in PsM. These electives are related to patient care and involve team working and may be exemplified by the so called "Peer Groups on History Taking". Members of these groups practice guided self-help and this in part overcomes the dissatisfaction amongst students caused by overpopulation of the medical school. In conclusion it is suggested that in West Germany, students should be exposed more often to places of primary care, and their lecturers should act as experts in group techniques applied to problem situations in primary care. Psychosomatic lecturers should concentrate on issues of primary care and act as supervisors of group work. They should also support student electives in PsM in order to promote interest in this subject.

Curriculum↗
PubMed1989

Psychosomatic medicine and primary health care (PHC).

Psychosomatic medicine emphasizes that mental and physical illness are inextricably linked and promotes a comprehensive approach to a patient's health problems. The article examines the principles of primary health care and demonstrates the importance of these notions to its development.

Humans↗
PubMed1995

[Somatization disorders in primary care: differential clinical aspects. Study Group of Psychic and Psychosomatic Morbidity of Zaragoza, Primary Care Section].

BACKGROUND: To identify specific sociodemographic and psychopathological features of somatization disorder (SD) patients in relation to other patients with psychiatric and organic morbidity in primary care (PC) setting. METHODS: A group of SD patients from PC was compared with other two control groups: the first one made of patients with psychiatric morbidity (with or without organic disease) and the second group of patients with only organic disease without psychiatric morbidity. Polivalent standardized psychiatric interview (PSPI), a specific psychiatric interview for PC settings, was used as diagnostic instrument. RESULTS: 1) there is a female predominance in SD statistically significant compared with organic patients and with a trend to significance in relation to psychiatric patients. Age, marital status and educational level show no significant differences among the groups; 2) in relation to psychopathology, SD patients show, in relation with organic patients, statistically higher levels in all items measured by PSPI. On the contrary, SD overwhelmed psychiatric patients in just four items: somatic symptoms, fatigue, reported anxiety and hystrionism as well as sexual problems and lack of social support, and 3) high psychiatric morbidity (85%) in SD, most of them affective and anxiety diagnosis, make it difficult to differentiate from the other patients suffering from psychiatric morbidity in PC. CONCLUSION: Patients with SD show a very different profile compared with those with organic disease in relation to psychiatric symptoms and social problems. On the other hand, when compared with patients with psychiatric disorders, differences are rather scarce. In addition, affective and anxiety comorbidity associated make it difficult the diagnosis. For this reason, the use of screening instruments for SD seems mandatory.

Adult↗
PubMed1998

Psychosomatic medicine and primary care in Germany.

The development and training in psychosomatic medicine in Germany are presented. This branch of medicine emphasizes the biopsychosocial understanding of disorders, and psychological, particularly psychoanalytic, methods are used. The outcome of treatment studies are awaited to clarify their role in the medical services of Germany.

Curriculum↗
PubMed2006

[Effectiveness of psychosocial interventions for emotional disorders by general practitioners. A systematic review].

OBJECTIVES: The introduction of psychosomatic primary care provides for the first time the possibility for general practitioners to treat emotional and psychosomatic disorders and problems which in the past were often not recognized. METHODS: Using computer-based searches in data bases and journals we surveyed controlled studies in which general practitioners performed psychosocial interventions. The studies were assessed according to standardized procedures for systematic reviews. RESULTS: A total of 9 studies were found which took place between 1966 and 2003. The clinical effects attained were usually limited and of short duration. Studies with specific therapeutic approaches in specific disorders showed the best results. CONCLUSIONS: Psychosocial interventions by the general practitioner are effective, but there is need for improvement. Further conceptual development of structured psychosocial interventions which can be applied in the general practice for the most common emotional disorders is necessary. Considering the large number of patients with emotional disorders in primary care, these efforts will undoubtedly be worthwhile.

Affective Symptoms↗
PubMed1997

[Contents of a "basic psychosomatic management" curriculum. Results of a 4-year concomitant evaluation].

The results of evaluations proceeding the educational seminar "Psychosomatic Primary Care" in South Baden are presented and analyzed. From 1991 to 1995, approximately 450 physicians took part in these courses. From critical feedback and suggestions for improvement obtained from participants following each course, recommendations for future seminars pertaining to content, structure, process, didactic and evaluation are presented.

Adult↗
PubMed2006

[Psychosomatic medicine in primary care].

Patients commonly visit their primary care physician (PCP) because of body symptoms. However, neither the PCP nor his patient can tell immediately whether or not psychosocial factors play a role in the disease manifestation. If this is the case, only a patient-centred approach and basic knowledge in biopsychosocial skills will help the PCP to diagnose and treat his patient appropriately. This article gives a comprehensive overview on how the PCP can approach patients with psychosomatic diseases (i.e. somatic symptoms exacerbated by psychosocial factors, medically unexplained symptoms, functional somatic syndromes, somatic manifestation of psychiatric diseases). Adopting this approach will allow the PCP to be challenged but not overburdened by, on an average, 30-50% of his patients presenting with psychosomatic symptoms.

Humans↗
PubMed1980

Psychosocial and psychosomatic diagnoses in primary care of children.

In this study in seven primary care facilities the proportion of children recognized as having behavioral, educational, or social problems was much higher than generally assumed. Although there was great variability among the facilities, at least 5% and as many as 15% of children seen in one year were diagnosed as having these problems in all but the hospital teaching facilities. The prevalence was even higher among children from poor families. The variability among facilities was much less for psychosomatic problems, which were diagnosed in 8% to 10% of the children. For both psychosocial and psychosomatic types of problems, but especially for psychosocial ones, the proportion of visits with the diagnoses was much lower than the proportion of children with them, so that these problems engendered fewer visits for their management than might have been expected from their frequency in the population. However, available evidence suggests that individuals with unresolved psychosocial problems make more than their share of visits for other diagnoses. The findings of this study have implications for the content of educational programs for primary care practitioners, for the organization of primary care practice, and for the current debate over policy concerning reimbursement and benefit packages.

Adolescent↗
PubMed2002

[Developing a network for psychosomatic medicine and psychotherapy in Austria].

In Austria additional in-patient treatment facilities for psychosomatic patients are currently established. In this context an advisory board of the planned psychosomatic clinics suggests to develop a network for psychosomatics and psychotherapy. This suggestion focuses on four goals: further integration of specialised psychosomatic care into general medical care; further promotion of general psychosomatic care in primary health care; increasing acceptance of psychotherapy among psychosomatic patients in need of psychotherapeutic interventions; decreasing the number of chronic psychosomatic disorders by early and adequate treatment. The proposed network should involve three levels of cooperation: the primary care level, the specialised psychosomatic-psychotherapeutic level and the institutional level of planning future structural developments according to the actual needs and demands. Such a network should also facilitate a common approach regarding the admission of patients, in-patient treatment and post-treatment care. A need inventory and an implementation analysis involving all levels of cooperation as well as the patients perspective are regarded as a prerequisite for the implementation of the network.

Aftercare↗
PubMed2002

[Psychosomatic research in primary health care--ideal concept and reality].

UNLABELLED: The cooperation between research institutions and primary care doctors can be seen as a possible model for practical research in psychosomatic medicine. Cooperation experience with a study in the field of sexual medicine are reported as well as recommendations regarding the planning and implementation of similar studies are given. 7455 Swiss physicians specialized in psychiatry, internal or general medicine were asked to fill out a survey on "sexual dysfunction and anti-depressants". They were also asked if they were willing to interview their patients on the same issue. 1100 physicians agreed to answer the doctors survey and 62 were interested in interviewing their patients. However, only 12 physicians actually did. In 55 telephone interviews doctors mentioned as their main reasons for not participating: lack of time and their hesitation to discuss sexual issues with depressive patients. CONCLUSION: The collaboration in research projects means a considerable effort on the side of primary care doctors. Therefore, their cooperation should be rewarded appropriately, e.g. time could be counted as further training.

Academies and Institutes↗
PubMed2000

[Not Available].

It may be possible to identify elements of psychosomatic/psychotherapeutic pri-mary care in the Federal Republic of Germany and the former German Democratic Republic by comparing the current state of basic psychosomatic care (BPSC) in the eastern and western part of Berlin. 278 Berlin patients with psychosocial problems were recruited 1995 for a basic documentation system of the BPSC in connection with a project supported by the Federal Ministry for Health at the Berlin Center. Their data were compared with re-gard to diagnostic and therapeutic measures applied in the eastern and western part of Berlin. Furthermore, 617 questionnaires on basic psychosomatic care were filled out by physicians in private practice in both parts of the city in 1994. Despite the identical or lower assessment of their patients* biopsychosocial stress, East Berlin physicians take considerably more therapeutic measures than their collea-gues in West Berlin. There are only minor differences between physicians from the eastern and western part of the city despite variances in the training and advanced training systems for BPSC. The possible causes are discussed.

Diagnosis↗
PubMed1992

[Psychosomatic treatment of irritable bowel syndrome].

Irritable bowel syndrome (IBS) may be defined as a psychosomatic disease. Most primary care physicians do not want to undertake psychosomatic treatment, but may find it necessary in refractory patients. Brief psychosomatic treatments, providing patients with betterways to cope with stress, reduce the symptoms. The literature on the psychosomatic treatment for IBS is summarized. Supportive therapy and autogenic training that produce relaxation response appear to be effective. Other special psychological therapies that require specialized training, such as hypnosis, biofeedback, cognitive therapy, transactional analysis may be used for IBS but adequately controlled trials are lacking. It is certain that psychosomatic treatment take part in the management of IBS. Additional studies are needed to verify the effectiveness of these treatment for IBS.

Autogenic Training↗