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Apart from rehabilitation research, there have been no studies regarding the expectations of patients with chronic back pain in terms of inpatient multimodal pain therapy. The aim of this naturalistic longitudinal study is to explore treatment expectations, their fulfilment, and influence on the treatment success of inpatient multimodal pain therapy.This study included 118 patients with chronic back pain who were physically examined and assessed for their psychological comorbidity. They were interviewed pre and post pain therapy. Treatment expectations were recorded via the questionnaire for assessing rehabilitational expectations and motivations (FREM-17), and further variables via the Pain Disability Index (PDI, german version) and the german Hospital Anxiety and Depression Scale (HADS-D).The results show that treatment expectations have an impact on therapy success or failure. In particular, patients' expectations of coping with illness and recovery could be met by inpatient multimodal pain therapy, whereas health and pension-related expectations remained unfulfilled. In addition to the treatment expectations, the therapy result was primarily determined by the patient's ability to perform before the therapy.From the clinical side, treatment expectations should be explored and checked for feasibility to avoid patient disappointment.HINTERGRUND: Bislang gibt es außer in der Rehabilitationsforschung keine Untersuchungen hinsichtlich der Erwartungen von Patienten mit chronischen Rückenschmerzen an eine stationäre multimodale Schmerztherapie. Ziel dieser naturalistischen Längsschnittstudie ist es, Behandlungserwartungen, deren Erfüllung sowie Einfluss auf den Behandlungserfolg einer stationären multimodalen Schmerztherapie zu explorieren.In die Studie wurden 118 Patienten mit chronischen Rückenschmerzen eingeschlossen, die körperlich untersucht und hinsichtlich ihrer psychischen Komorbidität beurteilt wurden. Sie wurden prästationär und poststationär nach Abschluss der Schmerztherapie befragt. Die Behandlungserwartung wurde über den FREM-17 (Fragebogen zur Erfassung von rehabilitationsbezogenen Erwartungen und Motivationen) erfasst, außerdem wurden der Deutsche Schmerzfragebogen, PDI (Pain Disability Index, deutsche Version) und HADS‑D (Hospital Anxiety and Depression Scale, deutsche Version) eingesetzt.Insgesamt zeigen die Ergebnisse der Studie, dass die Behandlungserwartungen einen Einfluss auf den Therapieerfolg oder -misserfolg haben. Insbesondere die Erwartungen der Patienten an Krankheitsbewältigung und Erholung konnten durch die stationäre multimodale Schmerztherapie erfüllt werden, wohingegen die gesundheits- und rentenbezogenen Erwartungen unerfüllt geblieben sind. Neben den Behandlungserwartungen wurde das Therapieergebnis vor allem durch das vor der Therapie bestehende Leistungsvermögen der Patienten determiniert.Von klinischer Seite sollten die Behandlungserwartungen vor Beginn einer multimodalen Schmerztherapie exploriert und auf Realisierbarkeit geprüft werden, um Enttäuschungen auf Patientenseite zu vermeiden.

The aim of this cross-sectional study was to explore the psychological and physical well-being of patients with chest pain depending on availability cardiological disease (coronary heart disease, different cardiological disease, no cardiological disease, unclear diagnose).In a total of 383 cardiological outpatients, anxiety and depression (HADS) as well as physical complaints (B-L) were assessed.For half of the outpatients, no cardiological diagnose was found that explained the symptoms of chest pain. In comparison to the general population, outpatients with various cardiological symptoms exhibited a lower psychological and physical well-being independent of availability cardiological disease. 50.9% of the outpatients showed elevated anxiety scores, 35.2% showed elevated depression scores and 71.7% felt impaired by physical complaints. In comparison to males, females were more anxious and exhibited a lower physical well-being. In general, physical impairment increased with age, while anxiety decreased.The present study discovered a very high psychological comorbidity in cardiological outpatients with chest pain that underlines the necessity of an integrated psychosomatic care regardless of clinical finding. In order to understand the symptom of chest pain it is not indicated to differentiate between cardiologically vs. psychologically ill patients.

The influence of psychotherapeutic interventions on the long-term course of anxiety and depression of inpatients of a Gynaecological University Hospital was examined in a prospective naturalistic provision study. All patients admitted to hospital within a year were examined regarding anxiety and depression (HADS). The patients who had conspicuous values in their questionnaires were randomly assigned to an intervention or a control group. There was a follow-up examination for them one year after the first examination. In the first examination 715 participants took part, in the follow-up examination there were 429. Women with malignant gynaecological diseases suffer more severely from anxiety (t=7.02; p0.001) and depression (t=3.87; p0.001) in comparison with the normal population. Women suffering from general gynaecological (t=7.75; p0.001) and obstetrical diseases (t=5.95; p0.001) are significantly more anxious. Whereas the anxiety in patients with general gynaecological (F=3.02; p=0.031) as well as in patients with obstetrical diseases (F=3.52; p=0.017) can be reduced significantly in the long-term by psychotherapeutic interventions, depression cannot or only slightly be influenced. This shows that low-frequent psychotherapeutic interventions with psycho-educative, supportive approaches (e. g. in the framework of psychosomatic consultation and liaison service) have positive effects on anxiety in the long run, whereas depression is to be influenced rather by long-term interventions or classic depth-psychological or behaviour therapeutic interventions.

The desire and necessity for psychosomatic support were investigated in a gynecological ward of the University of Dresden clinic. Data on anxiety, depression, physical complaints, physical as well as psychological quality of life were collected. The 392 examined women were admitted to the hospital because of gynecological, obstetric or oncological diseases. 39.5 % of the examined patients expressed a desire for psychosomatic support during their stay. Anxiety and depression levels of these patients were higher and the psychological quality of life level lower than for those without the desire for psychosomatic support. Comparing gynecological, obstetric with oncological patients the latter show higher levels of depression and lower psychological quality of life. In contrast the physical quality of life is the lowest for obstetric patients. Our results show that inpatients of a gynecological clinic are physically and psychologically impaired and have a high desire for psychosomatic support.

Analisi del testo e della musica del Lied "Die Forelle" (D 550) e del quarto movimento del quintetto per pianoforte e archi (D 667) di Franz Schubert, nella prospettiva di una didattica dell'ascolto che punti alla comprensione critica ed estetica dell'opera d'arte musicale. Per la stesura dell'articolo sono state svolte ricerche di prima mano nella Arbeitsstelle della Neue-Schubert-Ausgabe (Tübingen).