Psychosomatic medicine in primary care: influence of training.

BACKGROUND: General practitioners (GPs) are often confronted with patients presenting somatic symptoms presumed to be decisively modulated by psychosocial factors. OBJECTIVES: We aimed to explore GPs' reported clinical routine in dealing with these patients according to the GPs' level of training in psychosomatic medicine. METHODS: A structured postal questionnaire survey was conducted among all Austrian GPs with a standardized training background in psychosomatic medicine (three levels of training; duration between one and six years) as well as in a random national sample of Austrian GPs without such training, resulting in four study subgroups. RESULTS: Respondents estimated that between 20% and 40% of their patients presenting somatic symptoms need psychosocial factors to be addressed. Study subgroups differed significantly concerning their reported diagnostic and therapeutic routine behavior patterns. Some diagnostic approaches such as clarification of lay etiology increased linearly with the level of training. The proportion of patients receiving corresponding treatment in the GP's own practice was also reported to increase with the level of training (no training: 35%, levels one and two: 46%, level three: 54%), although all subgroups estimated that over 20% of patients do not receive any corresponding treatment. CONCLUSIONS: Results point at the clinical relevance of a general training in psychosomatic medicine in primary care. They also suggest specific training effects that need to be substantiated in observational studies.

[Austrian Network for Psychosomatic Medicine: background, development and participation]. / Aktuelle Informationen aus der Deutschen Gesellschaft für Psychosomatische Medizin und Arztliche Psychotherapie.

OBJECTIVES: Physicians as well as the general public need easy access to information on regional psychosomatic treatment options as can be provided by a network website. We therefore set out to explore the readiness of the Austrian psychosomatic community to participate in a network for Psychosomatic Medicine and actively contribute to its website. METHODS: All Austrian psychosomatic societies and all psychosomatic in-patient facilities were addressed personally and/or by letter. Through articles published in medical journals, physicians in private practices specialized in psychosomatic-psychotherapeutic medicine were also invited to participate. RESULTS: All departments of medical psychology and psychotherapy, all psychosomatic societies and all psychosomatic in-patient facilities in Austria decided to participate in this network. In addition, 100 physicians in private practice applied for registration in the network. DISCUSSION: These results support the network concept and have led to its implementation, and clearly, the network should be further developed. The first precondition for its functioning seems to be met.