title: [Treatment of non-specific, functional and somatoform bodily complaints].
abstract: In primary and secondary medicine "non-specific, functional, and somatoform bodily complaints" are common and often take a chronic course, with the patients' quality of life usually markedly impaired, and give rise to high direct and indirect costs. They are challenging as they can deteriorate in case of inappropriate behavior on the physician's part. Coordinated by both German professional associations of Psychosomatic Medicine a new evidence based guideline was developed, aiming to transfer relevant diagnostic and therapeutic knowledge to all physicians who are in charge of these patients. After establishing a stable therapeutic alliance a symptom- and coping-oriented attitude could be demonstrated to be helpful. A biopsychosocial diagnostic evaluation combines a thorough assessment of bodily complaints and early introduces a sensitive discussion of signs of psychosocial stress, which can be extended carefully in case problems of this type are present. In less severe courses, physical/social activation is recommended and the patient's explanatory disease model should be extended towards a psychological dimension. More severe and complicated courses require a more structured approach consisting of regular appointments (as opposed to ad-hoc appointments whenever the patient feels worse) and an active cooperation of the patient. A coordinated, multimodal management includes additional measures as graded activation, psychotherapy, relaxation training or--if indicated--temporary medication.
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie der TU München.
authors.forename: H
authors.initials: H
authors.lastname: Sattel
authors.affiliation: Klinik für Allgemeine Innere Medizin und Psychosomatik, Universitätsklinikum Heidelberg.
authors.forename: R
authors.initials: R
authors.lastname: Schaefert
authors.affiliation: Klinik Innere Medizin I, Klinikum Saarbrücken gGmbH.
authors.forename: W
authors.initials: W
authors.lastname: Häuser
authors.affiliation: Institut für Allgemeinmedizin der Otto-von-Guericke-Universität Magdeburg.
authors.forename: M
authors.initials: M
authors.lastname: Herrmann
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie der TU München.
authors.forename: J
authors.initials: J
authors.lastname: Ronel
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie der TU München.
authors.forename: P
authors.initials: P
authors.lastname: Henningsen
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie der TU München.
authors.forename: C
authors.initials: C
authors.lastname: Hausteiner-Wiehle
mesh_terms: D003131:Combined Modality Therapy / Q000379:methods / Q000523:psychology; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D019983:Guideline Adherence; D006801:Humans; D033183:Interdisciplinary Communication; D010348:Patient Care Team; D010349:Patient Compliance / Q000523:psychology; D010358:Patient Participation; D010817:Physician-Patient Relations; D011379:Prognosis; D011613:Psychotherapy; D011788:Quality of Life / Q000523:psychology; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*