RESUMEN
People with rare diseases have a very high rate of mental and social stress. This results in specific tasks and problems in the psychosomatic care of patients. On the one hand, the physical and/or psychological symptoms of an undetected rare organic disease can be misdiagnosed as a psychosomatic disease, and the affected persons possibly receive psychotherapy that is not causally effective. On the other hand, mental diseases that require treatment can arise as a result of the effects of a rare disease. These should be diagnosed as such and treated with psychotherapy. If, in individual cases, both symptoms of a rare disease and symptoms of a psychosomatic disorder in the sense of comorbidity are present, neither one nor the other diagnosis should lead to a hasty termination of diagnostic efforts. Otherwise, misalignments can easily occur and the further diagnostic and therapeutic process can be permanently disturbed. Interdisciplinary team care interventions should therefore be developed further.