Aspects of therapy in psychosomatic medicine.

An inquiry into the selection of patients at the Heidelberg Psychosomatic Clinic confirmed that in the process from diagnosis to psychotherapy the selection had the tendency to exclude more those patients without higher education, those aged over 30 years, and those transferred from other clinics. Patients with psychosomatic disorders or physical ailments are not subjected to this negative selection. However, they come less often to the clinic of their own accord, are usually less well-educated, have vague ideas about therapy or expect to have medicines prescribed, and generally are less aware than neurotics of having contact problems with others. After combined verbal and pre-verbal inpatient therapy and two years of outpatient group therapy, personality changes are apparent both in neurotics and psychosomatic patients. Studies with Giessen Tests show that changes are even greater in the psychosomatic group.