[Psychosomatic in gynecology and obstetrics--problems and difficulties (author's transl)].

The hypo-, hyper- and normogonadotropic amenorrheas (according to WHO nomenclature) are psychosomatic amenorrheas. The significance of the various psychic factors is pointed out initially. Especially with psychosomatic disorders in gynecology sexual factors play an important role. Adequate treatment of psychosomatic disorders is rendered difficult of the present state of medical education. Lectures in psychosomatics are not presented outside of psychiatry, the dialogue between doctor and patient is almost completely neglected within the medical training. Psychosomatic treatment in the office of patients with state medical insurance poses problems. At our clinic an outpatient department has been open for 2 years. 136 cases have been treated so far. Gynecologist and the psychosomatic specialist examine the patient simultaneously and define a joint treatment plan. Prevailing problems are conflicts with the partner (31%), , conflicts within the family (20%) and conflicts within the social environment (13%). Following adequate diagnostic clarification patients are treated once (19%) or several times (28%) or are referred to other outpatient clinics. A prolonged therapy in our own outpatient department is presently possible in only 2,5% of cases.