Stressreaktivität vor und nach integrierter akutpsychosomatischer Komplexbehandlung

Zusammenfassung

Formen der autonomen und hämodynamischen Dysregulation sind mit einem erhöhten Morbiditäts- und Mortalitätsrisiko assoziiert und gelten als Begleiterscheinungen einiger psychosomatischer Störungsbilder. Unklar ist, ob stationäre Psychotherapie einen Effekt auf die physiologische Stressreaktivität hat und ob Zusammenhänge mit der Veränderung von psychometrischen Befunden bestehen. 77 Patienten wurden zu Beginn und zu Ende stationärer psychosomatischer Komplexbehandlung psychometrisch (PHQ, HADS) und psychophysiologisch (Herzrate, Blutdruck, Herzindex, kardiale Gesamtbelastung, kardiozirkulatorische Effizienz, Präejektionsperiode, LF-HRV und HF-HRV) unter verschiedenen Testbedingungen (Ruhe, Kopfrechnen, Angerrecall, Erholung) untersucht. Die Behandlung ging mit einer signifikanten Verbesserung der Symptome einher, während die physiologischen Aktivierungsparameter keine signifikanten Veränderungen zeigten. Ob weiterführende Maßnahmen im Anschluss an die Therapie auf längere Sicht einen günstigen physiologischen Effekt haben, bleibt zu untersuchen.

Abstract

Autonomic imbalance and exaggerated stress responses are associated with an increased risk of morbidity and mortality and have been associated with several psychosomatic disorders. Has in-patient psychotherapy any effect on autonomic regulation and mental stress reactivity? In 77 patients undergoing in-patient psychometric treatment psychometric examination and psychophysiological assessment of hemodynamic and autonomic parameters during rest and 2 mental stress tests was performed at the beginning and at the end of in-patient psychotherapy. Despite marked improvements in symptoms our short-term treatment for psychosomatic disorders did not affect autonomic and hemodynamic activation at rest or during stress testing. It remains to be investigated if increased physical activity and relaxation expected after improvement have beneficial physiological effects over longer time spans.

Schlüsselwörter

psychophysiologische ­Stressreaktivität - autonome Regulation - kardiozirkulatorische ­Regulation - Psychotherapieeffekt

Keywords

psychophysiological ­stressreactivity - autonomic regulation - cardiocirculatory regulation - effects of psychotherapy

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