Kramer R, Meissner B, Schultze-Berndt A, Franz I-W
Klinik Hüttenbühl der BfA, Bad Dürrheim.
Dtsch Med Wochenschr. 2003 Jul 4;128(27):1470-4. doi: 10.1055/s-2003-40290.
The course of chronic diseases does not only depend on the patients' physical situation but also on their psychological state of mind. Therefore, inpatient medical rehabilitation has to aim at including psycho-social features present themselves at the beginning and at the end of inpatient rehabilitation - and, even more importantly, six months afterwards.
For half a year all patients of an internistic rehabilitation clinic were taking part in a long- term baseline-study. They have been questioned about anxiety, susceptibility to depression, aspects of quality of life and about their body weight, using a standardized questionnaire. The analyzed total spot check (n = 1222) consisted of cardiological (n = 197; mean age 53,5 +/- 10,9 years), pulmonary (n = 709; mean age 47 +/- 11,2 years) and breast cancer patients (n = 277; mean age 54,2 +/- 8,8 years) and n = 39 could not be classified.
At the onset of rehabilitation all patients suffered significantly more from anxiety than from depression. Accordingly, of the cardiological and pulmonary group 12.2 % or 10.9 % respectively showed a clinically strong depression and 27.9 % or 27.1 % respectively revealed remarkable values in anxiety. Moreover, 17.8 % of the cardiological and 14.7 % of the pulmonary patients stated a remarkable restriction of their fitness. Unexpectedly, the statements of the breast cancer patients group showed lower rates in all these categories. Six months after termination of rehabilitation, a significant long-term improvement of anxiety could be observed, especially for those patients who had had the highest values before. This also applies to patients who had stated the highest depression values initially. In addition, there was also a significant improvement in the capability for fitness, pleasure, relaxation and contact - while the BMI benefited, too.
The data show that the psychological comorbidity of patients in inpatient medical rehabilitation is much higher than that of the general population and that of the general population and the psycho-social situation, especially for psycho-social very stressed patients, improves considerably on a long-term basis.
慢性病的病程不仅取决于患者的身体状况，还取决于他们的心理状态。因此，住院医疗康复必须旨在纳入住院康复开始和结束时——更重要的是，康复六个月后出现的心理社会特征。
半年来，一家内科康复诊所的所有患者都参与了一项长期基线研究。使用标准化问卷询问他们的焦虑、抑郁易感性、生活质量方面以及体重情况。分析的总抽查样本（n = 1222）包括心脏病患者（n = 197；平均年龄53.5 +/- 10.9岁）、肺部疾病患者（n = 709；平均年龄47 +/- 11.2岁）和乳腺癌患者（n = 277；平均年龄54.2 +/- 8.8岁），另有n = 39例无法分类。
康复开始时，所有患者的焦虑程度均显著高于抑郁程度。相应地，心脏病组和肺部疾病组分别有12.2%和10.9%表现出临床严重抑郁，分别有27.9%和27.1%的患者焦虑值显著。此外，17.8%的心脏病患者和14.7%的肺部疾病患者表示其健康状况受到显著限制。出乎意料的是，乳腺癌患者组在所有这些类别中的比率较低。康复结束六个月后，可以观察到焦虑有显著的长期改善，尤其是对于之前焦虑值最高的患者。这也适用于最初抑郁值最高的患者。此外，在健康能力、愉悦感、放松能力和人际交往方面也有显著改善——同时身体质量指数（BMI）也有所受益。
数据表明，住院医疗康复患者的心理合并症比普通人群高得多，而且心理社会状况，尤其是心理社会压力很大的患者，在长期内有相当大的改善。
