[Inadequate utilization of somato-medical services by psychogenically ill patients]

Within the Mannheim Cohort Project on the epidemiology of psychogenic disorders 240 probands of a high risk sample (suffering from medium psychogenic impairment) were randomly selected from the general population and investigated with regard to their realized utilization of the medical and/or psychotherapeutic services of the health care system. On the basis of clinical criteria the probands were classified as case (n = 78) of psychogenic disorder or non-case (n = 162). Increased psychogenic impairment caused by psychoneurotic, character neurotic, or psychosomatic-functional disorders was primarily combined with an intensified utilization of the somatically oriented medical services. Only 2.5% of the cases indicated that the reason for their most recent visit to a physician was psychotherapeutic treatment. In view of the high percentage of psychogenic impaired patients in private practices and general hospitals this seems to be a particularly discrepant finding. In spite of the psychogenic nature of their complaints the cases were confronted with somatically oriented therapy offers like the non-cases. An increased psychogenic impairment did not lead to a qualitative alteration of the utilization of medical and/or psychotherapeutic services. Facing the fact that the utilization of somatically oriented medical services by psychogenic ill patients is still widespread but inadequate this finding is interpreted as indication for an essential demand of further studies on the determinants of psychotherapy acceptance.