[Inpatient treatment for refractory PSS]

Persistent somatic symptoms (PSS) is an umbrella term for physical symptoms lasting several months that limit daily functioning or cause significant distress, regardless of their etiology. Treatment can be effective, but in refractory PSS, which is often accompanied by severe functional impairments, treatment may fail or even have adverse effects. In clinical practice, inpatient admission is often considered in such cases. Two case studies illustrate the challenges and outcomes of inpatient treatment for refractory PSS. Patient A benefited from a structured and planned biopsychosocial approach, which led to improved functioning and reduced suicidality. In contrast, Patient B had a negative experience due to the absence of jointly established expectations and disappointment with the diagnostic procedures. These cases highlight the importance of a well-prepared admission process, in which the patient, relatives, and involved healthcare professionals discuss expectations and reach agreement on concrete goals to enable an effective start to the recovery process.