[Psychological interventions in patients with chronic physical diseases and psychological comorbidity]

The term chronic physical disease summarizes various diseases characterized by a multifactorial genesis, long-term and often progressive course, as well as frequent restricting physical and psychosocial sequelae. Over the last 2 decades, research in medical psychology has demonstrated high prevalence rates of psychological comorbidity among patients with chronic medical conditions, indicating an urgent need for psychosocial treatment. The goal of psychosocial interventions is to reduce adverse disease consequences and improve quality of life. The intervention programs can be differentiated according to target populations, healthcare models, indications, treatment models, and treatment settings. They range from rather general approaches based on broad psychosocial support, health promotion, and patient education programs to problem-specific interventions. Concerning theoretical approaches, cognitive-behavioral interventions currently dominate; however, psychodynamic oriented and mixed approaches are being increasingly implemented. Reviews and meta-analyses of evaluation studies demonstrate the efficacy of these programs. However, there is still a discrepancy between psychotherapeutic options for patients with chronic physical diseases and their practical implementation.