Abstract

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.

Highlights

  • Almost 70 years ago, Mc Rae suggested that the adrenal gland is a crossroad of psychosomatic medicine [1]

  • Numerous psychiatric disorders are associated with the overproduction of corticotropin-releasing hormone (CRH), a peptide hormone controlling the activity of the hypothalamic-pituitary-adrenal axis (HPAA) and regulating the synthesis of adrenal steroids

  • This study demonstrates that the specialized spa therapy with physical activity and an optimized daily regimen substantially improved the endocrine balance in postmenopausal females, aged 50+, resulting in a persisting consolidation of their mood and physical health

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Summary

Introduction

Almost 70 years ago, Mc Rae suggested that the adrenal gland is a crossroad of psychosomatic medicine [1]. A central concept of psychosomatic medicine is the close interconnection of mentality with body function and condition [2,3]. CRH overproduction in the central nervous system (CNS) and periphery and disruption of the HPAA are typical for such somatic complaints as autoimmune, allergic, gastrointestinal, and chronic inflammatory diseases, as well as altered pain perception. In these diseases, the CRH operates on both peripheral and central levels [4,5]. The CRH indirectly operates in an anti-inflammatory fashion via the stimulation of anti-inflammatory cortisol and immunoprotective adrenal androgens [6], while the autocrine/paracrine peripheral effect is the opposite [7]

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