Improving the Biopsychosocial Competence of German Primary Care Physicians in Diagnosing and Treating Somatoform Disorders

In 1994, psychosocial primary care (PPC) was established as a standard part of the postgraduate training of general practitioners (GPs) in Germany. Despite the introduction of PPC, treatment of somatizing patients remains difficult for most GPs. The authors briefly review the history of psychosomatic medicine in Germany and the development of PPC. Next, they describe current training efforts in PPC, including curricular goals and theoretical approaches. Subsequently, they present results from evaluations of the training and describe the development of quality management techniques. Results of a randomized controlled trial of a new treatment model demonstrated that effects of reattribution techniques, in contrast to routine PPC, have been small and limited to physical functioning. Finally, the authors address challenges that PPC currently faces and its future.