title: [Patients with ICD-10 disorders F3 and F4 in psychiatric and psychosomatic in-patient units - who is treated where? : Allocation features from the PfAD study].
abstract: BACKGROUND
  In Germany, in-patient treatment of patients with depressive, neurotic, anxiety, and somatoform disorders (ICD-10 F3, F4) is carried out in different settings in psychiatry and psychosomatics. Which patient characteristics determine referral to one or the other specialty is a crucial question in mental health policy and is a matter of ongoing controversy. However, comparative data on patient populations are widely lacking.
  
  
  METHODS
  In the study of Treatment Pathways of Patients with Anxiety and Depression (PfAD study), a total of 320 patients with ICD-10 F3/F4 clinical diagnoses were consecutively recruited from four treatment settings (psychiatric depression ward, psychiatric crisis intervention ward, psychiatric day hospitals, or psychosomatic hospital units; 80 participants per setting) and investigated.
  
  
  RESULTS
  In all treatment settings, patients with considerable severity of illness and chronicity were treated. Female gender, higher education, and higher income predicted referral to psychosomatic units; male gender, transfer from another hospital or emergency hospitalization, co-morbidity with a personality disorder, higher general psychiatric co-morbidity, and danger to self at admission predicted referral to psychiatric unit. Patients in psychosomatic units had neither more psychosomatic disorders nor more somatic problems.
  
  
  CONCLUSIONS
  There is considerable overlap between the clientele of psychiatric and psychosomatic units. Referral and allocation appears to be determined by aspects of severity and social status.
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland. DanaMaria.BichescuBurian@zfp-zentrum.de.
authors: D
authors: D
authors: Bichescu-Burian
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
authors: C
authors: C
authors: Cerisier
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
authors: A
authors: A
authors: Czekaj
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
authors: J
authors: J
authors: Grempler
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
authors: S
authors: S
authors: Hund
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
authors: S
authors: S
authors: Jaeger
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
authors: P
authors: P
authors: Schmid
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
authors: G
authors: G
authors: Weithmann
authors: Klinik für Psychiatrie und Psychotherapie I, Universität Ulm/Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Str. 2, 88214, Ravensburg, Deutschland.
authors: T
authors: T
authors: Steinert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D004522:Educational Status; D005858:Germany / Q000453:epidemiology; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D038801:International Classification of Diseases; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D011611:Psychosomatic Medicine / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D017678:Sex Distribution; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Anxiety; Depression; Psychiatry; Psychosomatics; Referral