Department of Rehabilitation Medicine, 3rd Faculty of Medicine, Charles University, 12808 Prague, Czech Republic.
Institute of Endocrinology, 11694 Prague, Czech Republic.
Int J Mol Sci. 2019 Jul 27;20(15):3687. doi: 10.3390/ijms20153687.
Spa treatment can effectively reestablish mood balance in patients with psychiatric disorders. In light of the adrenal gland's role as a crossroad of psychosomatic medicine, this study evaluated changes in 88 circulating steroids and their relationships with a consolidation of somatic, psychosomatic and psychiatric components from a modified N-5 neurotic questionnaire in 46 postmenopausal 50+ women with anxiety-depressive complaints. The patients underwent a standardized one-month intervention therapy with physical activity and an optimized daily regimen in a spa in the Czech Republic. All participants were on medication with selective serotonin reuptake inhibitors. An increase of adrenal steroidogenesis after intervention indicated a reinstatement of the hypothalamic-pituitary-adrenal axis. The increases of many of these steroids were likely beneficial to patients, including immunoprotective adrenal androgens and their metabolites, neuroactive steroids that stimulate mental activity but protect from excitotoxicity, steroids that suppress pain perception and fear, steroids that consolidate insulin secretion, and steroids that improve xenobiotic clearance. The positive associations between the initial values of neurotic symptoms and their declines after the intervention, as well as between initial adrenal activity and the decline of neurotic symptoms, indicate that neurotic impairment may be alleviated by such therapy provided that the initial adrenal activity is not seriously disrupted.
水疗治疗可有效重建精神障碍患者的情绪平衡。鉴于肾上腺在身心医学中的交叉作用,本研究评估了 46 名患有焦虑抑郁症状的绝经后 50 岁以上女性的 88 种循环类固醇的变化及其与经改良的 N-5 神经症问卷中躯体、身心和精神成分的巩固之间的关系。这些患者在捷克共和国的温泉浴场接受了为期一个月的标准化运动和优化日常方案的干预治疗。所有参与者都在服用选择性 5-羟色胺再摄取抑制剂。干预后肾上腺类固醇生成增加表明下丘脑-垂体-肾上腺轴恢复。这些类固醇的许多增加对患者可能是有益的,包括具有免疫保护作用的肾上腺雄激素及其代谢物、刺激精神活动但防止兴奋毒性的神经活性类固醇、抑制疼痛感知和恐惧的类固醇、巩固胰岛素分泌的类固醇以及改善外来异物清除的类固醇。神经症症状的初始值与其干预后的下降之间以及初始肾上腺活性与神经症症状下降之间的正相关关系表明,这种治疗可能减轻神经症损害,前提是初始肾上腺活性没有严重受到干扰。