[Therapeutic referral of male/female patients--results of a catamnestic follow-up].

Patients who came to the outpatient clinic of the Psychosomatic Clinic of the University of Heidelberg in the time between April and August 1990 were investigated concerning compliance and referral into a psychotherapeutic network. Besides describing this process, the investigation looked for possible predictors of compliance. In the beginning we collected sociodemographic and clinical patient data, prognostic evaluations by the therapists as well as the quality of the therapeutic working alliance both in self-ratings and therapist-ratings. Two months after completion of the outpatient process, the patients received a follow-up questionnaire inquiring about the state of referral as well as a retrospective view of their experience in this process. The return was at 75% very satisfying. Approximately 2/3 of the patients had taken up on the referral suggested and of these 3/4 were already in therapy. Compliant and non-compliant patients differed only in the quality of the working alliance as seen by the therapist and here in the direction of a more difficult relationship with non-compliant patients. The analysis of those patients, who either did not participate in the investigation or only partially, demonstrates that the very good quota of patients referred may not just be extended from the compliant patients to include all outpatient patients. Hypothetically four problem groups may be described when taking the working alliance and the prognostic evaluation into consideration; these necessitate a specific therapeutic approach. Further research on the psychotherapeutic function of psychosomatic-psychotherapeutic outpatient clinics is therefore necessary.