[Symptom validity in psychosomatic rehabilitation]

This study investigates how patients in psychosomatic rehabilitation are characterized, who show conspicuous response behavior in a symptom validation test. At the same time the question of whether patients with an unlikely response behavior may benefit from psychosomatic rehabilitation will be pursued.

What proportion of patients in an inpatient psychosomatic rehabilitation clinic shows results in their symptom validation test that lack clear interpretability due to unlikely complaint representation? How can this group of patients be characterized? How effective is the psychosomatic rehabilitation treatment in patients who stand out by an unlikely response style?

Patients completed a questionnaire at the beginning and the end of their inpatient psychosomatic rehabilitation treatment. Questionnaire included socio-demographic information, Health49, SPE, DIAMO, FBTM and SIMS. Additionally, data from the discharge letter were considered.

24.6% of 329 patients showed conspicuous response behavior. Patients with conspicuous complaint representation were more likely to have an immigration background, rather belonged to the socio-economic underclass and more frequently showed a vulnerable gainful employment. There was no correlation between SIMS and the rehabilitation outcome. Patients with conspicuous response behavior and with high depression scores benefited significantly less from the inpatient treatment. Differences in the ability to work assessment were not found.

Conspicuous response style is associated with high scores on the clinical symptom scales. About one quarter of patients in an inpatient psychosomatic rehabilitation clinic needs a more accurate diagnosis in order to reliably assess the clinical prognosis and the ability to work.