The relevance of psychosomatic and psychotherapeutic in--and--out patient service is evident. Two important examples of psychosomatic care are described: somatoform and cardiovascular disorders. Quality assurance is necessary. There are data concerning the efficacy and the cost-benefit relation.
Research in the routine field of psychiatry must include psychiatrists in private practice. A majority of psychiatric patients is treated as outpatients and many of these are only seen by private psychiatrists. Setting or patient variables pose restrictions on the therapy which leads to the development of specific treatment strategies. Because these are empirically based, it can be expected that the knowledge of practitioners can make a major contribution to the development of optimal treatment recommendations. Research in private practice requires special organisational efforts. One way to get access to this field are collaborative study groups which bring together scientists and their research facilities with practitioners and their surgeries. Such an instrument may allow: access to patients, which may never show up in any other research institution; monitoring of patient characteristics and treatment modalities under routine conditions; elaboration of special skills, insights and treatment strategies developed by the practitioner. These study groups can vary with regard to type of practice, type of collaboration and type of research. Studies can rely on information from patient self-reports, observations by the practitioners themselves or their office assistants and on data gathered by scientific staff working occasionally or continuously in the practice.
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