The development of guidelines for the treatment of patients with mental disorders under particular consideration of rehabilitative aspects

Inpatient psychotherapeutic treatment is quite extensive in Germany. Three treatment systems (psychosomatic/psychotherapeutic healthcare, psychiatric/psychotherapeutic healthcare and rehabilitation of patients with mental disorders) exist relatively independently from one another. They show large areas of overlap, however, with regard to various criteria. This is due to the fact that, as opposed to many somatic illnesses, a clear distinction between acute-medical and rehabilitative elements cannot be made in the treatment of mental disorders. Systematic treatment recommendations in the form of guidelines could aid in determining the optimal treatment form for patients. The current development of guidelines for mental disorders will thus be presented and analyzed in this article. Particular focus will be placed on rehabilitative aspects. The presentation and analysis will take place using the example of guidelines written for panic disorders. Based on a national and international investigation of guidelines (internet, databases) 11 guidelines for panic disorder (2 German guidelines, 9 from English spoken countries; target group of 9 guidelines: general practitioners; recommendations concerning diagnostics /assessment and treatment) were analysed. The results demonstrate a considerable need for development as rehabilitative elements are only marginally mentioned in the guidelines up to now. Of the 16 rehabilitative elements being investigated, only two ("psycho education" and "pharmacotherapy of chronic illness in the long-term perspective") are considered more than once in the guidelines. Seven elements (e.g. "salutogenic aspects of the therapy/ measures for the maintenance of quality of life", "methods of long-term guidance") are not mentioned at all. Based on the results of the analyses performed, conclusions for the further development of guidelines will be presented for discussion.