[Medical expertise of chronic pain syndromes by psychotherapists].
Chronic pain is the most frequent symptom leading to medical expertise in general medicine, orthopedics, neurology and psychiatry. Because of the importance of psychosocial factors in the onset and the course of chronic pain syndromes a basic psychosomatic diagnostic in every medical expertise of chronic pain is necessary. In case of hints to relevant psychosocial factors in the onset and the process of chronicity of the pain syndrome a psychotherapeutic medical expertise for the assessment of the form and the severity of the psychic disorder and psychosocial conflicts as causes, consequences or comorbidities of the pain and its social consequences is mandatory. Within a structured procedure using international diagnostic systems and classifications of severity scores and disabilities an reproducible assessment of performance is possible. The guidelines of the German psychosomatic and psychotherapeutic scientific societies for medical expertising are presented with their relevance to the assessement of patients with chronic pain syndromes. Furthermore the authors discuss based on their own experiences and the literature some controversial issues between medical experts and officials in charge of pension insurance companies.
Häuser
W
W
Zentrum für Schmerztherapie und Medizinische Klinik I - Funktionsbereich Psychosomatik, Klinikum Saarbrücken, Germany.
Sonntag
B
B
Tiber Egle
U
U
D002908:Chronic Disease; D006233:Persons with Disabilities / Q000523:psychology; D006801:Humans; D001523:Mental Disorders / Q000503:physiopathology / Q000523:psychology; D010146:Pain / Q000523:psychology*; D011613:Psychotherapy; D012720:Severity of Illness Index; D013577:Syndrome