PSYCHOGENIC DISORDERS IN PRIMARY-CARE

The treatment of psychogenic disorders in Germany is mainly done by ge neral practitioners. Therefore, we investigated the frequency of psych ogenic disorders in 18 general practitioners' offices and describe med ical and psychosocial aspects of this health care system. 572 patients after the general practitioner's consultation were examined and diagn osed by a psychotherapist (among others Impairment Score, DSM-III-R cl assification). We also collected patients' self-ratings by questionnai res (SCL-90-R, questions about subjective illness theory). 36,4% of pa tients fulfilled relevant DSM-III-R criteria and showed considerable i mpairment (IS > 4). By means of SCL-90-R, 31,7% Pre classified as psyc hogenically ill. There is no sex difference in the frequency of psycho genic disorder, but in DSM-III-R diagnostic range. Totally, the genera l practitioners with 11,5% of their patients lead a conversation in th e sense of psychosomatic basic care, but only 3,3% are referred to psy chotherapy. These numbers are higher with psychogenically ill patients who themselves assume a psychic cause of their illness. Our data docu ment the importance of psychosomatic medicine and the general practiti oners' psychosomatic basic care in their diagnostics and therapy.