The Role of Primary Care Practitioners in Psychosocial Care in Germany
Steffen Häfner, MD; Ernst-Richard Petzold, MD
Winter 2007 - Volume 11 Number 1
Several epidemiologic studies in Germany have shown that about 25% of the general population suffer from psychogenic disorders that fulfill the criteria of a case that needs treatment.1,2 These figures are comparable to data from the National Comorbidity Study (NCS)3 in the US or the Edmonton Study4 in Canada. Many of these patients are seen by general practitioners (GPs).
The treatment of psychogenic disorders in Germany is mainly done by GPs. Physicians, especially GPs, have a major screening function in the care of patients suffering from psychologic disorders.5 Zintl-Wiegand and Cooper6 point out that it was the studies of Michael Balint and his co-workers7 as well as the distribution of Balint groups in general medicine that played an important role so that the influence of psychodynamic concepts was ultimately greater in the group of GPs than in other medical disciplines.8 The diagnosis and therapy of somatoform disorders are often difficult and unsatisfactory for the attending physician. Multiple diagnostic tests, ineffective treatment, and time absent from work create high costs for the social security system.9 It is obvious with this group of patients that GPs have responsibility in terms of screening, filtering, prevention, and treatment. Glaesmer and Deter10 showed how costs can be reduced with psychosomatic basic care offered by GPs.