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This paper is the result of a symposium that addressed the problem of disablement and social pension for patients with psychosomatic-rheumatological complaints. This especially concerns patients suffering from psychosomatic manifestation at the locomotor apparatus, who are increasingly disabled and necessitating a pension, without actual somatic findings justifying a vocational disablement. Primarily it is a clinical picture of a generalized tendomyopathy, often underestimated in its importance. Definitions, causes, and clinical pictures are presented. A critical phase decisive for the disablement, the personality of the would-be pensioner, considerations for the physician regarding diagnostic and therapeutic efforts, elements of time and environment, and conditions at the work-place are discussed. In some cases a pension will be unavoidable and justifiable, even if the somatic findings seem not to be sufficient. The psychogenic picture must be carefully determined differentiated from simulation; determining the cause of aggravation is essential.

During the preparation of the government program "Health Research and Development", which was started in 1978, an attempt was made to involve the scientific community directly in establishing priorities for research on rheumatic diseases. At a planning conference open to all interested research scientists the following questions were considered: 1. What are the methodological requirements for therapeutic trials? 2. What are the open questions in the field of clinical rheumatology and which of them should be given priority? 3. What are the conditions for running multicenter therapeutic trials successfully? This paper describes the methodology and the results of the analysis of research needs and priorities and discusses the special problems of clinical rheumatology research in the Federal Republic of Germany.