[Somatic rehabilitation as a field of work for psychologists: results of a nationwide survey of structures and practice in orthopaedic and cardiac inpatient medical rehabilitation]. / Die somatische Rehabilitation als Arbeitsfeld für Psychologen: Ergebnisse einer bundesweiten Befragung zu Strukturen und Praxis in der stationären orthopädischen und kardiologischen Rehabilitation.

OBJECTIVE: A detailed analysis of the present structural quality and practice of psychological services in inpatient medical rehabilitation facilities was conducted. The study was carried out for the indications chronic back pain and coronary heart disease. METHODS: A nationwide postal survey of psychological services in orthopaedic and cardiac inpatient rehabilitation facilities was carried out. RESULTS: Data from psychology departments of 169 orthopaedic and 75 cardiac inpatient rehabilitation facilities are available. In both indication areas an average of one psychologist is in charge of 100 patients. In the treatment of patients with chronic back pain and coronary heart disease, several methods of psychological assessment and a wide range of psychological interventions are being applied. On the whole, there are notable parallels between the psychological interventions provided to patients with chronic back pain and coronary heart disease. At the same time, however, there is considerable heterogeneity among rehabilitation facilities as to the psychological interventions carried out. DISCUSSION/CONCLUSION: The heterogeneity found reveals the low degree of standardization of psychological practice in medical rehabilitation of patients with chronic back pain or coronary heart disease. This emphasizes the need for developing and implementing recommendations or practice guidelines for psychological interventions.

Somatic healthcare utilization among adults with serious mental illness who are receiving community psychiatric services.

BACKGROUND/OBJECTIVE: Somatic health care utilization was studied among individuals with serious mental illness who were receiving community-based psychiatric services. RESEARCH DESIGN: Cross-sectional study. SUBJECTS: A total of 200 outpatients, 100 with schizophrenia and 100 with affective disorder, were recruited from randomly selected samples receiving care at two psychiatric centers. MEASURES: Patients were interviewed using questions from national health surveys. Multiple logistic regression analyses were used to compare responses from each sample to those of matched subsets of individuals from the general population. RESULTS: The psychiatric samples were more likely to report receiving some medical care services in the past year than were individuals in the general population including having visited a general medical doctor (Odds ratio, schizophrenia sample = 2.04; Odds ratio, affective disorder sample = 2.37) and having a complete physical examination (Odds ratio, schizophrenia sample = 2.69; Odds ratio, affective disorder sample = 1.74). However, our samples were less likely to receive routine dental care (Odds ratio, schizophrenia sample = 0.46; Odds ratio, affective disorder sample = 0.60). Perceived barriers to receiving medical care were reported significantly more often by the patient groups than the comparison groups (Odds ratios > 3). CONCLUSIONS: General health services are widely utilized by individuals with serious mental illness who are in outpatient psychiatric care. Dental services remain underutilized, however, and there is a high rate of perceived barriers to receiving medical care in this population.