RESUMO
Psychosomatic medicine has undergone dynamic development in the Czech Republic in recent years. The Society of Psychosomatic Medicine of the Czech Medical Association of J. E. Purkyne was founded in 2014. It develops both the professional side of this field and strives for better integration of psychosomatic care into the Czech health care system. After several years of effort, it succeeded in obtaining approval of the medical procedure code in the field of psychosomatics (909) "psychosomatic intervention". The text of Recommended Diagnostic and Therapeutic Procedures for Psychosomatic Care describes the recommended movement of the psychosomatic patient through the health care system, diagnostic categories in psychosomatic medicine and related differential diagnosis, and basic diagnostic units in psychosomatic medicine.
RESUMO
OBJECTIVES: The aim of the study was to determine the status of the autonomic nervous system (ANS) in anxiety disorder patients and to evaluate possible exercise intervention in order to improve the ANS and overall psychiatric status of patients. PATIENTS AND METHODS: The ANS function was monitored via means of heart rate variability (HRV) changes during a 6-week hospitalization at the Psychiatric Clinic of University Hospital in Olomouc. The status of ANS was monitored by the new evaluation method of spectral analysis (SA) of HRV. The research involved 43 anxiety patients (29 women and 14 men) who underwent six weeks of intensive psychotherapy; part of the test group also participated in regular aerobic exercise. RESULTS: In the sense of autonomic dysfunction we can not give clear-cut answers to the question whether the autonomic dysfunction could be one of the predictors of anxiety disorder, although our results suggest lower vagal representation in the spectra. Unlike in the healthy population the exercise had a positive impact only on a limited number of patients. Regular endurance exercise on a stationary bicycle had a positive impact on the ANS efficiency only in patients with primary ANS activity reduction. In patients with normal ANS efficiency the exercise intervention had no effect; in some cases we even found activity reduction during the hospitalization period. However, the exercise had a positive effect on the course and outcome of the applied therapy in all patients. CONCLUSIONS: ANS disturbances have not been exhibited in some patients suffering from anxiety disorder. Due to the positive impact of regular physical activity on cardiovascular, metabolic, neural, and psychological changes in organism, monitored exercise should be implemented into therapeutic programs for patients with anxiety disorders.