Psychosocial stress increases cardiovascular risk, which coincides with enhanced oxidative DNA damage. Increased sympathetic tone-related catecholamine release causes oxidative stress, which contributes to catecholamine-related cardiotoxicity. Therefore, we tested the hypothesis whether acute psychosocial stress induces oxidative DNA damage, its degree being related to the cardiovascular risk profile and depending on the sympathetic stress response. After assessment of the prospective cardiovascular Münster score (PROCAM) to determine the risk of acute myocardial infarction, 83 male and 12 female healthy volunteers underwent the Trier social stress test for groups (TSST-G). Heart rate variability was quantified by measuring the standard deviation (SDNN) and root mean square of successive differences (RMSSD) between normal-to-normal inter-beat intervals. Salivary α-amylase (sAA) activity was assessed as a surrogate for noradrenaline plasma concentrations. Oxidative DNA damage was determined using whole-blood single-cell gel electrophoresis (“tail moment” in the “comet assay”). A total of 33 subjects presented with a prospective risk of myocardial infarction (risk+) vs. 59 subjects without risk (risk-). The TSST-G stress significantly increased blood pressure, heart rate, and sAA in both groups, while oxidative DNA damage was only increased in the risk+ group. Immediately after the TSST-G, the “tail moment” showed significant inverse linear relations with both SDNN and RMSSD. Acute psychosocial stress may cause oxidative DNA damage, the degree of which is directly related to the individual cardiovascular risk profile and depends on the stress-induced increase in the sympathetic tone.

Clinical experiences using a psychosomatic-oriented multimodal treatment approach in patients with post-COVID are promising. We established a half-day multimodal treatment program for post-COVID patients at the Department of Psychosomatic Medicine at General Hospital Nuremberg, Paracelsus Medical University, Germany. This observational study between January 2022 and March 2023 comprised baseline documentation of Patient Health Questionnaire (PHQD), ICD-10 Symptom Rating (ISR), Fatigue Scale (FS) and Health Status Questionnaire (SF-12) at admission and discharge of 65 patients suffering from post-COVID. Multimodal psychosomatic treatment was scheduled for 3-4 weeks. At admission, PHQ and FS showed a high level of somatic symptom burden (PHQ-15: M = 16.0, SD = 5.6) and fatigue symptoms (FS: M = 27.1, SD = 4.4). Depressive (PHQ-9: M = 14.0, SD = 5.3) and anxiety symptoms (GAD-7: M = 9.6, SD = 5.6) were moderately and mildly pronounced, respectively. Compared to patients from our standard clinical settings post-COVID patients had a comparably high or even higher mental symptom burden (e.g. PHQ-15: p < .001, d = 0.79; PHQ-9: p = .009, d = 0.39). Compared to admission, symptomatology of post-COVID patients at discharge was improved (e.g. PHQ-15: p = .004, d = 0.26; FS: p = .009, d = 0.32). Despite the short duration of treatment, the patients showed a significant reduction in symptoms between admission and discharge. Further data including a control group and extending the duration of treatment will show whether the changes in symptoms are of the multimodal psychosomatic treatment.

Weltweit endet jede sechste Schwangerschaft in einer Fehlgeburt [1] und über 3000 Kinder wurden in Deutschland 2022 tot geboren [2]. Der unerwartete Verlust kann bei den Betroffenen neben Trauer, Wut und Ohnmacht auch Gefühle wie Schuld und Scham auslösen. Auch deshalb, weil die Ursachen oft unklar bleiben. Diese vielschichtigen und teils ambivalenten Gefühle können es erschweren, das Erlebte zu verbalisieren. Mit der emotionalen Ausnahmesituation fühlen sich betroffene Frauen oft allein gelassen, gerade weil Fehl- und Totgeburt noch immer ein Tabuthema sind. Der Verlust eines ungeborenen Kindes kann so zu einer hohen psychischen Belastung führen. Studien bestätigen, dass Frauen nach einer Fehl- oder Totgeburt verstärkt unter Symptomen posttraumatischen Stresses sowie an Symptomen einer Angststörung oder Depression leiden [3], [4]. So erfüllen neun Monate nach einer Fehlgeburt 18 % der betroffenen Frauen die Symptome einer posttraumatischen Belastungsstörung (PTBS) [4]. Ob sich nach einer Fehl- oder Totgeburt eine Traumafolgestörung entwickelt, hängt auch davon ab, ob Betroffene professionelle Unterstützung erhalten, um mit dem Ereignis emotional fertig zu werden [3]. Article published online: 05 March 2024 © 2024. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany