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Aims:
Psychological traumatization and psychological symptoms are very relevant in medical care and represent a challenge for the physician-patient interaction, especially in a gynaecological setting. Despite progress in recent years, clinical care of such patients is still inadequate. The aim of this study was to examine 1) the influence of early/current psychological traumatization on the physician-patient interaction, 2) the correlation between psychological traumatization and current psychological distress, and 3) influencing factors on the part of gynecologists (e.g., professional experience or additional trauma-specific training) on physician-patient interactions in gynaecological routine examinations.

Methods:
We assessed 200 gynaecological outpatients prospectively in a tertiary somatic hospital. Before a gynaecological routine examination, the patients completed validated questionnaires on early and current psychological traumatization (CTQ, IES-R) and current psychological distress (HADS, FDS-20, ISI, Distress Thermometer). After the examination, patients rated the quality of the physician-patient interaction (PRA-D). Subsequently, gynaecologists indicated whether they assumed psychological traumatization and/or psychological distress (yes/no) in the particular patient.

Results:
Overall, patients scored high on the quality of physician-patient interaction (M = 98.62, SD = 7.35, scale range from 15 to 105). The quality of physician-patient interaction did not differ between patients with vs. without psychological traumatization (.236 ≤ p ≤ .456). Current psychological distress was significantly higher in patients with early and/or current psychological traumatization than in patients without psychological traumatization (.001 ≤ p ≤ .049). Professional experience and trauma-specific training among gynaecologists were positively associated with patients' score of physician-patient interaction. Gynaecologists were able to identify both psychological traumatization and current psychological distress.

Conclusions:
Early and/or current psychological traumatization were associated with higher levels of current psychological distress in gynaecological patients. Trauma-specific training and professional experience on the part of gynaecologists led to a better physician-patient interaction, highlighting the importance of such additional training. These skills are likely to play an important role when adapting communication in psychologically traumatized patients.

Acknowledgments:
This study was funded by the Research Commission of the Cantonal Hospital St.Gallen. There are no conflicts of interest.