[Psychotherapeutic and psychosocial therapy in general practice. Results of demonstration project on quality management in psychosocial primary care].
Since 1987, psychosocial primary care (PPC) provided by General Practitioners, are reimbursed by German health insurances. The aim of the psychosocial primary care is to improve recognition and treatment of mental disorders in the primary care sector. As a part of a eight-center national demonstration program on quality management in the outpatient services, General Practitioners (n = 191) from 5 regions participated in the study. 1341 treatment episodes of patients with predominately psychosocial strain were documented. Differences between psychosocial strain, treatment and outcome were determined by analyses of variance. Men and patients beyond the age of 65 were underrepresented. Psychosocial treatments were offered more often to those patients, who had the highest level of anxiety and depression. Patients with physical illness, with pain and without psychological attribution to the illness belief were offered less psychosocial interventions and reached a worse outcome. The study outcome helps to improve training programs as to recognition and treatment of psychosocial problems in primary care. Male and generally elderly patients with somatic symptoms and lack of psychological attribution need a special psychosocial intervention to improve the outcome.
Fritzsche
K
K
Abt. für Psychosomatik u. Psychotherapeutische Medizin, Universitätsklinik für Psychiatrie u. Psychosomatik, Freiburg.
Sandholzer
H
H
Werner
J
J
Brucks
U
U
Cierpka
M
M
Deter
H C
HC
Härter
M
M
Höger
C
C
Richter
R
R
Schmidt
B
B
Wirsching
M
M
D000328:Adult; D000553:Ambulatory Care; D005194:Family Practice / Q000379:methods* / Q000592:standards; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010865:Pilot Projects; D011613:Psychotherapy / Q000592:standards*; D011785:Quality Assurance, Health Care; D012944:Social Support