[Supported aftercare into psychosomatic rehabilitation - transfer of "new credo"]

In recent years the prevalence of psychosomatic illnesses increased considerably, therefore the relevance of medical rehabilitation is also increasing. The effectiveness of psychosomatic medical rehabilitation has been demonstrated, but only a small proportion of rehabilita-tion patients manage to transfer the rehabilita-tion success into the daily routine. Numerous -aftercare offers should stabilize the effects of -rehabilitation. Against this background, a new -rehabilitation aftercare strategy ("New Credo"), initially developed and evaluated with good -results for orthopedic indications, was tested for psychosomatic indications. The aim of the present study was to test the concept in a psychosomatic rehabilitation clinic in terms of feasibility (feasibility-study). Further an evaluation of the results of the new credo can be made by the use of a "historical" control group.

In a longitudinal feasibility study with 3 points of measurement (before and after rehab as well as after 4 months) the feasibility and acceptance of the new credo was examined. One psychosomatic rehabilitation clinic in Schleswig-Holstein participated in the study, included were rehabilitation patients with depressive disorders (F32.x, F33.x und F40; ICD-10). The new credo philosophy was implemented in the clinical routine as well as the supporting materials were -applied during the project duration. During the study period the clinic was provided with a person in charge for the aftercare program. Psychological symptom severity (BSI) was defined as primary outcome variable. Secondary outcome variables were the subjective health, restriction in participation as well as health-related quality of life. Complete data were available for 91 rehabilitation patients. They were compared with matched data in terms of age, gender and school education from the "Qualitätsgemeinschaft medizinische Rehabilitation in Schleswig-Holstein".

The new credo is also in psychosomatic rehabilitation well-accepted by all persons involved. The rehabilitation pa-tients used their rehabilitation stay to find a suitable activity for themselves for the time after rehabilitation. The majority evaluated the keeping of the diary as positive. In the primary and secondary outcome variables are medium to big effects visible in regard of short- to fairly long-term improvements. In the comparison with the "historical" control group on the level of intra-group effects remains an advantage in favor of the new credo.

The new credo proved to be also feasible for rehabilitation patients with depressive disorders, the rehabilitation- and aftercare strategy was well-accepted by the clinic and the rehabilitants. Most of the rehabilitation patients evaluated the new rehabilitation philosophy and the accompanied aftercare positively. First promising results indicate an increased sustainability of rehabilitation success using the new credo. Their validation in a multicenter controlled study design remain to be seen.