[Chronic neuroses and their treatment]

Research in epidemiological psychiatry begins to find methods which allow a sufficiently reliable and valid assessment of the prevalence and incidence of neurotic disorders. Neuroses seen by psychiatrists more often show a chronic development than those seen by general practitioners. Chronic neurotic patients run a higher risk of somatic disorder but rarely become addicts. A minority only of equally disturbed neurotics receives any kind of treatment. This is only partially explained by the uneven distribution of services by region and social class. --According to twin research results, whether a neurosis appears at all, and its severity and chronicity, seem to be less influenced by heredity than the "choice" of symptoms. Controlled research begins to outline indications for the various forms of psychotherapy. One of the most important results is that psychotherapy does not have to last long to be helpful. Many neurotics, however, remain ill in spite of being treated. Unfavourable familial and other psychosocial factors can sustain the disorder, whereas unforeseen changes in the life situation may occasionally lead to late recovery.