[Medicalization of social problems using the example of patients with pain]

The number of invalidity pensions for mental and psychosomatic disorders has dramatically increased in the last decade. Given the experience in sociomedical assessment of people with chronical pain diseases, we developed the impression that primarily social problems-especially long-term unemployment-play an important role in the processes of chronification of pain diseases. We evaluated 100 expert opinions from 2002-2007 according to quantitative and qualitative critieria. We found that at the time of applying for retirement nearly the whole sample was long-term unemployed and that the especially these people suffered from diseases characterized by pain at the beginning of their patient career and they all had received a large range of diagnostic and therapeutic interventions. Only during the course of their disease-usually after the rejection of their application for pension by expert medical opinions-did they receive the diagnosis in the field of psychiatry and psychosomatics. In a next step they were assessed by experts in the field of psychiatry and psychosomatics. In this article, the important social factors that influence this development are discussed.