Epidemiological data concerning physical illness of the chronic psychiatric outpatients are scarce and incomplete. Somatic illness and complaints in the described population proves to be high. Research of factors involved in missing a somatic diagnosis in this patient population is lacunar. A standard protocol in the evaluation of physical health is not available. Somatic evaluation facilities for psychiatrists working with the chronic psychiatric outpatients in the Netherlands are insufficient.

The introduction of a probleminventory, designed to collect systematic information regarding 4 levels of functioning of the chronic psychiatric outpatient facilitated an integrative view of somatic problems in the context of the other problemareas of the patients. These levels of functioning are physical level, individual level, family level and sociocultural level. A pragmatic approach was postulated in which the actual proces of somatic diagnosis was described as a specific task of the psychiatrist; the integration of somatic disturbance however was a specific task of the therapist of the concerning patient regardless of his professional background. This hypothesis is illustrated by 4 casehistories. A research project concerning epidemiological factors of somatic illness and factors affecting a deffective somatic evaluation of the chronic psychiatric outpatient population is announced.