Wilfer Tobias, Braungardt Tanja, Schneider Wolfgang
Klinik und Poliklinik für Psychosomatik und Psychotherapeutische Medizin Universitätsmedizin Rostock Gehlsheimer Str. 20 D-18147 Rostock Deutschland Klinik und Poliklinik für Psychosomatik und Psychotherapeutische Medizin, Universitätsmedizin Rostock.
Z Psychosom Med Psychother. 2018 Sep;64(3):250-261. doi: 10.13109/zptm.2018.64.3.250.
Social problems in primary care Objectives: Social problems appear in clinical work as well as in expert opinions for courts and insurances as a major factor in frequently chronic psychosomatic diseases, both in the professional and private environment. On the assumption that unemployed individuals show a higher risk for the development of mental and psychosomatic diseases, we investigated our hypothesis that mostly social issues lie at the center of patients' motivation for consultations.
Our questionnaire was dispatched by the Medical Association of Mecklenburg-Vorpommern (MV) to all established general practitioners in that state (n = 1025). It collected information on how social problems were handled in primary-care practices.
The large majority of social problems in MV arise from unemployment and job-related conflicts. Doctors often evaluate these problems using pathological dimensions (medicalization) and provide certificates of disability as a "dysfunctional" approach to the problem.
The medicalization of social problems indicates a lack of alternatives in our medical system and highlights the inadequate handling up to early retirement based on dysfunctional behavior (incorrect diagnosis, certificate of disability).
