Die Rehabilitation
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Studies on selected populations lead to biased estimates of the prevalence of back pain and associated factors. In order to obtain a valid picture of the prevalence of back pain this review article focuses on epidemiological studies in the general population. These studies can be divided into general health surveys and surveys with specific reference to back pain. ⋯ Severe forms of back pain increase even in the higher age groups, especially in women. Beside this effect the reviewed articles show either no difference between men and women or only a slightly higher prevalence in women. The problems faced by epidemiological studies on back pain, resulting from different definitions of "the back", severity, chronicity and different methodology, are discussed in detail.
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In the wake of the disintegration of the policlinical system which had prevailed in the former German Democratic Republic, far-reaching restructuring has become necessary in the "new" German laender in the field of complementary psychiatric care. Establishment throughout the state of Saxony of a uniform outreach-based ambulatory service ranks as a first component towards building regionalized community psychiatric networks. In light of some twenty years of experience in the old laender, this function is considered a task of the Social Psychiatric Services ("Sozialpsychiatrische Dienste", SPDIs). ⋯ The expectations SPDI staff hold relative to the therapeutic services to be rendered by themselves go beyond the scope of what has so far been implemented in their current activity, and qualitative content analyses are presented in the article for each of the areas concerned. Along with better staffing levels, removal of in-service organizational and further education deficits are identified by SPDI staff as the two main requirements for stabilizing their operations. In order to counter undue burdening of the SPDI with service expectations and to enable a more clear-cut positioning of its programme structures within a complex psychosocial service delivery system, it is necessary--at least in the state of Saxony--that further needs-oriented establishment and/or extension of community-based psychiatric services and agencies take place.