Kellner K
Prakt Anaesth. 1979 Jun;14(3):203-9.
Psychosomatic medicine in intensive care units is essentially characterized by problems arising from the emotional involvement of the intensive care unit team. That is why the functions of a psychosomaticist are not only the diagnostics of psychosyndromes and the psychotherapy of dangerously ill patients, but especially the study of psychological interrelations within the unit team. Hypochondriac depressive psychosyndromes caused by the experience of dread, confusion, exhaustion and communication problems, as well as psychosyndromes characterized by a reduction of consciousness and orientation are discussed. Anaclitic psychotherapy, i.e. supporting and encouraging care, and emergency psychotherapy actually required in precarious situations, are described. The specific interrelations within and between the individual groups of the intensive care unit team (physicians, female and male nurses), which are important to the working conditions in the unit, and the possibilities of their psychological activation (e. g. in Balint groups) are outlined. The status and responsibility of a psychosomaticist within the unit team is critically reflected. Finally, the permanent confrontation of the team with death and dying is emphasized, and the psychological aspect of discontinuing intensive care is discussed.
重症监护病房中的身心医学本质上是由重症监护病房团队情感投入引发的问题所决定的。这就是为什么身心医学专家的职能不仅包括对心理综合征的诊断以及对危重病患者的心理治疗，更重要的是研究团队内部的心理相互关系。文中讨论了由恐惧、困惑、疲惫和沟通问题引发的疑病抑郁心理综合征，以及以意识和定向力减退为特征的心理综合征。还描述了依附性心理治疗，即给予支持和鼓励的护理，以及在危急情况下实际需要的紧急心理治疗。文中概述了重症监护病房团队中各个群体（医生、男女护士）内部及相互之间的特定相互关系，这些关系对病房的工作条件很重要，还提及了激活他们心理状态的可能性（如在巴林特小组中）。文中批判性地反思了身心医学专家在团队中的地位和责任。最后，强调了团队与死亡和濒死状态的持续对峙，并讨论了停止重症监护的心理层面问题。
