[Psychosomatic medicine -- does it have the right to exist as a separate discipline?].

In their "Recommendations for Clinical Research at Medical Schools and Universities" (1986), the Scientific Council of the Federal Republic of Germany described the quantity and quality of psychosomatic and psychotherapy-research generally as unsatisfactory. Although meanwhile in some fields, such as epidemiologic longitudinal studies, comparative therapy evaluation of controlled individual case studies, research has reached good-quality standard, essential deficits still remain. There are several reasons for the delay in implementing psycho-somatic-psychotherapeutic research after the establishment of departments of psychosomatic medicine and psycho-therapy at Medical Schools in the Federal Republic of Germany in 1970. For example 1.) psychosomatic research covers almost all disciplines of clinical medicine. Therefore, a variety of special knowledge is required. 2.) Global psychological theories that marked the beginning of psychosomatic medicine are obviously inadequate in providing useful approaches to causal explanations in psychosomatic medicine. The cultural complexity of mental life determining the substance of psychoanalytical hypo-theses is apparently not reflected in the comparatively simple, phylogenetically rooted psychic factors leading to pathophysiological processes. As a consequence, psychosomatic research will have to concentrate less on global theories and to focus more on heuristic models of limited range specific to the respective functional systems or illnesses. The need to carry out examinations on both mental and physical level requires knowledge of either methodology. In addition, the necessary access to patients and laboratories suggests that psycho-somatic departments should be closely connected with those of internal medicine or one of the other departments with many psychosomatic problems. Research and advanced training in psychotherapy, on the other hand, should be performed in close cooperation with the one department responsible for research and the provision of care for the mentally ill, with psychiatry. Thus it would be possible to definitely improve the present situation, which is characterized by an overburden of the usually small departments of psychosomatic medicine and psychotherapy with matters of psycho-therapeutic training, research training, clinical work and teaching. At any rate, psychosomatic medicine is having great prospects, in particular concerning research. The departments of psychosomatic medicine and psychotherapy should be better prepared and equipped for these future tasks.