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Objectives: Attitudes towards communication skills of medical undergraduates can be gathered using the Communication Skills Attitude Scale (CSAS). We aimed to develop a German version of the CSAS (CSAS-G) in order to explore attitudes towards communication skills in a German cohort. Additionally the potential influence of demographic factors was examined.Methods: We realized the CSAS-G and conducted a survey with 529 participants from 3 different years of study. We then carried out an explorative as well as confirmatory factor analysis and compared the attitudinal scores. Multiple regression analysis was performed.Results: The confirmatory analysis confirmed the two-subscale system revealed by the explorative factor analysis. Students indicate low levels of negative attitudes and moderate levels of positive attitudes. Attitudinal scores differ significantly in relation to gender.Conclusion: The CSAS-G can be used in German cohorts to evaluate attitudes towards communication skills. Medical students in our study show basically a positive approach. Further investigation is necessary to explore and understand attitudes towards communication skills of German medical students.

Objectives: Utilization of the health care system is not determined by the presence of an organic illness, but by a multitude of interacting factors. This applies particularly to somatoform complaints and disorders, in the context of which the health care system is used very intensively and inadequately in relation to the disorder. The present paper summarizes the frequency of somatoform complaints in the general population and health care utilization due to these complaints., Methods: On the basis of a survey carried out in 2002 for a representative population of 2089 persons (aged 14 to 92 years), the prevalence of somatoform complaints during a period of 2 years was determined. In this survey, physical complaints were defined as being somatoform when they seriously affected the person's well-being but exhibited a disparity between objective diagnostic findings and subjective experience. The psychosocial aspects were also determined. When somatoform complaints were identified, the specific utilization of the healthcare system for them was investigated., Results: Somatoform complaints are very frequent in Germany: 8.3% of the population claim to suffer from clinically relevant somatoform disorders that fully meet the criteria mentioned above. The health care system is used heavily for these complaints. Within the last two years, each test person suffering from somatoform disorders consulted a physician a mean 18 times and was incapable of working for a mean of 20 days. 16% of these persons were hospitalized, 9 % received treatment at a health resort, 9 % retired, etc., Discussion: The considerable utilization of health care services is an essential element of somatoform pathology and has immense medico-political relevance. The most important prerequisite for handling the 'commitment to health care system' symptom is thorough training of all physicians in the basics of somato-psycho-social medicine. This will be an important measure for cost reduction in the health care system.

Aim: We investigate which articles out of the entire fifty volumes of the Zeitschrift fur Psychosomatische Medizin und Psychotherapie (Journal of Psychosomatic Medicine and Psychotherapy (Psychoanalysis) have been most frequently cited. These articles are analysed according to the groups of authors and topics., Methods: The citation frequency was determined in the source journals listed by the ISI and contained in the SCI and SSCI data banks., Results: 58 articles were cited at least ten times, and five of these articles were cited at least twenty times. One article was cited 45 times and thus was the top runner. The authors who are particularly important in their specialized areas dominated, and the most frequently cited articles were distributed quite evenly in both psychosomatic and psychotherapeutic topics., Discussions: A relatively large number of articles in this journal have a sustained influence among experts in the field. Since there are not many of German journal listed in the ISI data banks or have only recently been included by them, the number of citations is most likely considerably higher.