PubMed · 9354501
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B M Sucher. Disability Evaluation Certificate Program.. https://doi.org/10.1097/00002060-199709000-00020
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In 1997, 30% of the persons going into early retirement because of occupational disability and received pensions were psychosomatically ill. An additional large number of retirees suffered from untreatable pain such as chronic low back pain, some of them might as well have a chronic somatoform pain disorder. The article describes frequent psychosomatic diseases like somatization disorder, fibromyalgia and chronic fatigue syndrome with respect to their pathophysiology and psychological aspects as well as therapeutic advancements. It is postulated that an interdisciplinary access to these patients early in the course of their illness involving both somatic medical and psychiatric competence is the most promising means to tackle this enormous medical and health protection problem.
In 1999, the IV. civil division of the German Federal Supreme Court has issued a verdict which states that for some diseases the medical proof of a disease may be established solely on grounds of the individual complaints supporting the respective diagnosis. In the eyes of the psychiatrist, this statement is wrong and results from a confusion of diagnosis and disease. It also reveals a curious misconception of how psychiatric diagnoses, as instances of non-physical disorders, are established. Responsible for the confusion are the modern diagnostic manuals, which are misunderstood and thus misused as containing a list of diseases. However, the diagnostic manuals only intend to classify characteristic complexes of complaints and signs, without establishing them as diseases. The present paper explores the relationship between diagnosis and disease and explains how psychiatric diagnoses are made.
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