Von der angewandten Psychosomatik zur integrierten Medizin - Erfahrungen mit dem Steglitzer Belegbettenmodell

Deter, Hans‐Christian; Weber, Cora; Adolph, Dirk; Stehle, Sabine; Blum, Brigitta; Martienssen, Renate; Kallenbach, Bettina

doi:10.1055/s-2003-814789

Cited by 2 publications

(1 citation statement)

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“…In Germany, there were already models that provided for the psychosomatic care of “interspersed beds” [“Steglitzer Belegbetten-Modell” ( 63 )] or implemented the psychosomatic treatment unit [“Marburg Model” ( 64 )] on somatic wards. The outlined potentials were observed, but also difficulties in maintaining these structures due to a lack of specialized psychosomatic indication options since these models were the stand-alone treatment possibilities back then.…”

Section: Discussionmentioning

confidence: 99%

Specialized Biopsychosocial Care in Inpatient Somatic Medicine Units—A Pilot Study

Köbler

Krauss-Köstler

Stein

et al. 2022

Front. Public Health

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IntroductionSpecialized biopsychosocial care concepts are necessary to overcome the dualism between physical and psychosocial treatment in acute care hospitals. For patients with complex and chronic comorbid physical and mental health problems, neither standardized psychiatric/psychosomatic nor somatic care units alone are appropriate to their needs. The “Nuremberg Integrated Psychosomatic Acute Unit” (NIPA) has been developed to integrate treatment of both, psychosocial and physical impairments, in an acute somatic care setting.MethodNIPA has been established in inpatient internal medical wards for respiratory medicine, oncology and gastroenterology. One to two patients per ward are regularly enrolled in the NIPA treatment while remaining in the same inpatient bed after completion of the somatic care. In a naturalistic study design, we evaluated treatment effects by assessment of symptom load at admission and at discharge using the Patient Health Questionnaire (PHQ) and the Generalized Anxiety Disorder Scale-7 (GAD-7). Furthermore, we assessed the severity of morbidity using diagnosis data during treatment. At discharge, we measured satisfaction with treatment through the Patient Satisfaction Questionnaire (ZUF-8).ResultsData from 41 NIPA patients were analyzed (18–87 years, 76% female). Seventy-eight percent suffered from at least moderate depression and 49% from anxiety disorders. Other diagnoses were somatoform pain disorder, somatoform autonomic dysfunction, eating disorder and posttraumatic stress disorder. Hypertension, chronic lung diseases and musculoskeletal disorders as well as chronic oncological and cardiac diseases were the most common somatic comorbidities. Treatment resulted in a significant reduction of depressive mood (admission: M = 10.9, SD = 6.1, discharge: M = 7.6, SD = 5.3, d = 0.58, p = 0.001), anxiety (admission: M = 10.6, SD = 4.9, discharge: M = 7.3, SD = 4.1, d = 0.65, p< 0.001) and stress (admission: M = 6.0, SD = 3.6, discharge: M = 4.1, SD = 2.5, d = 0.70, p< 0.001). Somatic symptom burden was reduced by NIPA treatment (admission: M = 10.9, SD = 5.8, discharge: M = 9.6, SD = 5.5, d = 0.30), albeit not statistically significant (p = 0.073) ZUF-8 revealed that 89% reported large or full satisfaction and 11% partial dissatisfaction with treatment.DiscussionNIPA acute care is bridging the gap for patients in need of psychosocial treatment with complex somatic comorbidity. Further long-term evaluation will show whether psychosocial NIPA care is able to reduce the course of physical illness and hospital costs by preventing hospitalization and short-term inpatient re-admissions.

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Section: Discussionmentioning

confidence: 99%

Specialized Biopsychosocial Care in Inpatient Somatic Medicine Units—A Pilot Study

Köbler

Krauss-Köstler

Stein

et al. 2022

Front. Public Health

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Do Patients’ Symptoms and Interpersonal Problems Improve in Psychotherapeutic Hospital Treatment in Germany? - A Systematic Review and Meta-Analysis

Liebherz

Rabung

2014

PLoS ONE

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BackgroundIn Germany, inpatient psychotherapy plays a unique role in the treatment of patients with common mental disorders of higher severity. In addition to psychiatric inpatient services, psychotherapeutic hospital treatment and psychosomatic rehabilitation are offered as independent inpatient treatment options. This meta-analysis aims to provide systematic evidence for psychotherapeutic hospital treatment in Germany regarding its effects on symptomatic and interpersonal impairment.MethodologyRelevant papers were identified by electronic database search and hand search. Randomized controlled trials as well as naturalistic prospective studies (including post-therapy and follow-up assessments) evaluating psychotherapeutic hospital treatment of mentally ill adults in Germany were included. Outcomes were required to be quantified by either the Symptom-Checklist (SCL-90-R or short versions) or the Inventory of Interpersonal Problems (IIP-64 or short versions). Effect sizes (Hedges’ g) were combined using random effect models.Principal FindingsSixty-seven papers representing 59 studies fulfilled inclusion criteria. Meta-analysis yielded a medium within-group effect size for symptom change at discharge (g = 0.72; 95% CI 0.68–0.76), with a small reduction to follow-up (g = 0.61; 95% CI 0.55–0.68). Regarding interpersonal problems, a small effect size was found at discharge (g = 0.35; 95% CI 0.29–0.41), which increased to follow-up (g = 0.48; 95% CI 0.36–0.60). While higher impairment at intake was associated with a larger effect size in both measures, longer treatment duration was related to lower effect sizes in SCL GSI and to larger effect sizes in IIP Total.ConclusionsPsychotherapeutic hospital treatment may be considered an effective treatment. In accordance with Howard’s phase model of psychotherapy outcome, the present study demonstrated that symptom distress changes more quickly and strongly than interpersonal problems. Preliminary analyses show impairment at intake and treatment duration to be the strongest outcome predictors. Further analyses regarding this relationship are required.

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Von der angewandten Psychosomatik zur integrierten Medizin - Erfahrungen mit dem Steglitzer Belegbettenmodell

Cited by 2 publications

References 1 publication

Specialized Biopsychosocial Care in Inpatient Somatic Medicine Units—A Pilot Study

Specialized Biopsychosocial Care in Inpatient Somatic Medicine Units—A Pilot Study

Do Patients’ Symptoms and Interpersonal Problems Improve in Psychotherapeutic Hospital Treatment in Germany? - A Systematic Review and Meta-Analysis

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