[Psychosomatic rehabilitation of in-patients with somatoform disorders and of patients with social-medically relevant problems: results of a two-year follow-up].

The success of psychosomatic rehabilitation based on psychoanalytical therapy was analyzed within the framework of a two-year follow-up in patients with somatoform disorders and in patients with social-medically relevant problems, who had been on sick leave for more than six months. Both groups of patients are often considered to be difficult. They were compared with patients of other diagnostic categories and with patients with shorter periods of sick leave. All in all, the physical and mental state of health showed lasting improvement, and demands on the health service and frequency of days off sick decreased. Patients with somatoform disorders partly proved to be more seriously affected at the time of admission, treatment outcomes, however, were to a great extent comparable to patients of other diagnostic categories. Patients who had been on sick leave for more than six months were found to have been more seriously affected at the time of admission and also to have been unable to benefit from rehabilitation to the same degree as those with shorter periods of sick leave. The success of rehabilitation does not seem to depend so much on diagnostic categories but rather on the duration of disablement. In cases of inability to work a specific treatment that pays greater attention to the somatic concept of illness as well as the low level of motivation for psychotherapy in this patient group could lead to better treatment outcomes.