[Psychoneuroimmunology: an update]

[20 years of professional specialist for psychosomatic medicine and psychotherapy in Germany]

OBJECTIVE

This contribution provides an overview of the development of the professional specialty area of psychosomatic medicine and psychotherapy since its establishment by the German Parliament in 1992.

RESULTS

First, the reasons behind the decision to create this professional specialty are elucidated. Then, the three revisions of the official training regimen, the subsequent development of the number of specialists in both outpatient and inpatient sectors, and the development of hospital wards for psychosomatic disorders and rehabilitation clinics for this purpose are discussed. The creation of this specialty may be judged to have been a successful venture that has led to a better treatment of the concerned patients. The recent development of specific psychosomatic research points to the increasing emphasis on special studies of bio-psycho-social interactions, which in turn have shaped and will continue to shape the contours of this specialty.

DISCUSSION

The necessary further developments in continuing education as well as increasing cooperation with other disciplines and other pending decisions concerning treatment alternatives are discussed.

The subject, its biology, and the chronic recurrent cystitis

Functional disorders in urology are troubling for both patients and physicians. Moreover, advances in recent research promise to provide biological insights into psycho-neuro-endocrino-immunological pathways that are one important facet of chronic urogenital inflammations. We present a case of a middle-aged woman with long-lasting recurrent cystitis for which especially a psychosomatic approach helped to understand and cure the disorder. Altogether, as practitioners treat subjects, not illnesses, a biopsychosocial understanding of human disease should be taken into account in cases of chronic recurrent cystitis.