Feelings of stigmatization are an important somatopsychic consequence of psoriasis, affecting the quality of life. It is thus relevant to supplement reliable statements about the detailed changes of stigmatization experience and psoriasis over time. In this study we compared the Psoriasis Area and Severity Index (PASI), the 'self-administered PASI' (SPASI) and the 'Questionnaire on Experience with Skin Complaints' of 166 psoriasis patients (64 women, 102 men) in a 1-year follow-up to assess the relation between these factors over time. The results suggest a more pronounced feeling of discrimination in women with no significant somatic differences between gender at the first measurement. In a prospective evaluation we found a clear proportion of 'discordant' courses of these parameters, mainly in women, indicating a contradictory relation of somatic improvement or deterioration vs subjective experience with skin complaints. All in all, these results show a moderate but significant relevance of skin state for feeling of stigmatization over time only in men, thus suggesting a considerable influence of other psychic variables, probably coping skills, especially in women.

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The short form of the QES with 23 items is a valid instrument for the examination of social and psychic burdens of psoriasis and atopic dermatitis patients. The recording of the stigmatization feeling and of the quality of life determines different, supplementary aspects of the illness-related stress of patients with chronic skin diseases.

When initiated years after heart transplantation, longterm rehabilitation reduced coronary risk factors and significantly improved both the subjects' quality of life, as well as a near to normal capacity for physical work.

Quality of life was negatively affected by the onset of bronchiolitis obliterans syndrome. However, even patients who develop bronchiolitis obliterans syndrome reported a temporary benefit from lung transplantation. In addition to optimal medical care and efforts in preventing bronchiolitis obliterans syndrome, psychological support of lung recipients seems to be essential, especially when bronchiolitis obliterans syndrome occurs.

Starting from the psychosomatic patients in clinico-medical wards and the inherent two primary alexithymic features ‘highly limited introspective capacity’ and ‘very low motivation concerning dynamic psychotherapy’, which we proved empirically, we describe the therapist’s attitude and the three steps of supportive psychotherapy which initially represent the most indicated procedure in this patient group. In Hannover, this supportive psychotherapeutic procedure is applied by student auxiliary therapists. On the basis of our empirical findings, the effectivity of supportive psychotherapy, accomplished by students, in the alexithymic psychosomatic clinico-medical inpatients could be clearly demonstrated. Furthermore, we comment on some previous psychotherapeutic findings with regard to Crohn patients. Starting from our pretreatment and our follow-up measurements, we were able to prove that patients who were treated by both supportive psychotherapy and psychoanalytically orientated inpatient ward psychotherapy, showed remarkable improvements at all levels of the measurement techniques. Finally, we outline some clinico-psychosomatic aspects with regard to secondary alexithymia.

Objective: The aim of our study is to compare attitudes to psychotherapeutic treatment among patients with chronic skin diseases, outpatients from a clinic for psychosomatic medicine, psychology students, and medicine students. For this purpose, a questionnaire assessing the attitudes among patients and healthy individuals towards psychotherapeutic treatment and psychotherapists was developed. Subjects and Methods: 541 inpatients with chronic skin diseases, 218 outpatients from a clinic for psychosomatic medicine, 106 psychology, and 341 medicine students completed the Questionnaire on Attitudes towards Psychotherapeutic Treatment (QAPT). Results: Item analysis confirmed 20 out of the original 24 items. Four dimensions of the QAPT were determined: competence of the psychotherapist, judgment by others, general attitude, and acceptance. Conclusion: Data analyses showed that outpatients from a clinic for psychosomatic medicine and psychology students have a more positive attitude towards psychotherapy and psychotherapists than inpatients with chronic skin diseases and medicine students that hold more skeptical views on psychotherapy. This suggests that special efforts to inform and motivate patients with chronic skin diseases are required if psychotherapy is advisable.

The results of this study show that the participants of outpatient psychosomatic after-care are more restricted in their activity and participation than the control group. At the same time the reasons not to participate and the request for individual psychotherapy are discussed on the basis of the aims of pension insurance and the general acceptance of group psychotherapy.