[Documentation of psychosomatic and neurotic disorders (experience with the Heidelburg Symptom Diagnosis Register PSM-HD)].

A coding system for symptoms and diagnosis based on the ICD-Code is presented which is extended under psychological and psychosomatic veiwpoints and which comprises almost 200 codes of psychic (affective) and somatic complaints, psychic conflicts and types of personality. It is organised in two parts in that way, that the diagnosis of the symptoms and the diagnosis of the personality are recorded seperately. Counts on the different types of symptoms found in a sample of 1000 patients which came to a psychosomatic out-patient department in 1979 are represented. The anti-nosological attitude of the psychoanalysis is discussed and is seen as an impediment in the development of clinical practice with neurosis and psychosomatic diseases. The actually often contended symptom shifts, the increase of narcissistic disturbances, and borderlines can not be clarified without description of symptoms and terms, as well as many other questions without clarification of units of diseases. The anti-nosological attitude does not only hinder contacts with other medical subjects but also the further handling of the patient's body language, and that he can feel himself accepted and understood with his somatic symptoms. A descriptive approach to the complaints and symptoms of the patient is necessary as a first before a psychodynamic and development psychological deepening.