Concept of a day hospital. First clinical experiences

A day hospital was established as a ,,model of interdisciplinary management for diagnosis and therapy of chronic pain syndromes'', which extended the ambulatory facilities of our pain clinic. The psychosomatic concept is described. During its first 2 years 155 patients have been treated for chronic pain of multifactorial, non-malignant aetiology. Most of the patients were classified as being in advanced chronic stages which made a prognosis difficult. More than 80 % of them showed biographical and actual psychogenic stress factors; most frequently a depressive style of conflict-solving was found. At discharge from the day-care clinic, there was only little change in the severity of pain, however considerable improvement in somatic and psychic well-being. Problems of defining long-term outcome criteria for efficacy of pain treatment in a bio-psycho-social concept are discussed.