Differentiated view of psychological aspects concerning chronically ill adolescents with obesity, asthma, skin diseases and diabetes in medical inpatient rehabilitation. Do they need psychotherapeutic support?

Adolescents with a chronic somatic disease often show comorbid mental health problems which interfere with compliance and disease management. Compliance in chronically ill adolescents is classified low, so rehabilitation physicians are challenged by motivating their patients to organize their coping by following the medical guidelines. The present work describes how adolescents rate independent conversations with their rehabilitation physician and which factors (age, anxiety, excitement) have influence on the feeling of assurance in communication with the doctor. In addition it is discussed how far psychological signs and symptoms affect compliance and how medical inpatient rehabilitation supports the development of self-esteem and self-efficacy of chronically ill adolescents with and without psychological symptoms. As adolescents often pass their rehabilitation treatment without their parents and therapists frequently lack resources necessary for assessing information from both, the patients and their parents, it is discussed what conclusions can be drawn on the basis of self report data only and how general agreement between parent and adolescents can be rated