Psychosomatic consultation-liaison service in a psychiatric hospital comparative study on indications and on the success of different kinds of treatment

The concept and structure of care for mentally ill patients in the Central Institute for Mental Health (Zentralinstitut fur Seelische Gesundheit) in Mannheim, Germany, favors a close cooperation between the Psychiatric and the Psychosomatic Hospital, due to their being neighbours. There is a psychosomatic consultation-liaison service for the Psychiatric Hospital, for the first time this is being evaluated on the basis of an identical standardized patient record system. The study aims at finding out the criteria for the indication for a psychosomatic consultation in patients of the Psychiatric Hospital and far the resulting decision about further treatment. In this context several characteristics of the treatment course are also investigated. To test specific hypotheses and to analyze the process of treatment the total population of inpatients of each hospital from the same period as well as certain subsamples resp. control groups are used. The patients for which the psychiatrist suggested a psychosomatic consultation (N=178) showed more favorable social and illness-related characteristics than the total psychiatric population (N=5.223), especially if they were referred to the Psychosomatic Hospital for further, more intensive psychotherapeutic treatment (N=69). With regard to the treatment success rated by the doctor at the end of the treatment episode, the patients referred to the Psychosomatic Hospital do not differ from the patients who remained at the Psychiatric Hospital (N=109). Compared to the total Psychosomatic inpatient population (N=1.380), the treatment success of the patients referred from the Psychiatric to the Psychosomatic Hospital by the Psychosomatic consultation is evaluated as being rather more unfavorable.