Evidence map›Paper›PMID 41845331›Full record

Trial reportBMC complementary medicine and therapies2026

Effects of balneotherapy on stress, anxiety, and depression: results of a multicenter randomized controlled trial with six-month follow-up.

Lolita Rapolienė, Aelita Bredelytė, Giedrė Taletavičienė, Arvydas Balčius, Jūratė Astravaitė, Jovita Jočienė, Virmantas Rinkevičius, Antanas Danys, Liucija Patinskienė, Nerijus Kemeklis and 4 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMC complementary medicine and therapies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06018649 (The Effectiveness and Safety of Using Lithuania's Natural Resources to Improve Stress-related Mental and Physical Health), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06018649 naunknown statusnot on this map

The Effectiveness and Safety of Using Lithuania's Natural Resources to Improve Stress-related Mental and Physical Health

TypeinterventionalSponsorKlaipėda UniversityRan2023 to 2024Enrolled330ConditionsDistress, Emotional, COVID-19ArmsBalneotherapy plus complex, Combined nature resources treatment, Nature therapy procedure
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Lolita RapolienėKlaipėda University, Klaipėda, Lithuania. lolita.rapoliene@ku.lt.
Aelita BredelytėKlaipėda University, Klaipėda, Lithuania.
Giedrė TaletavičienėDruskininkai Hospital, Druskininkai, Lithuania.
Arvydas BalčiusHealth resort Draugystė, Druskininkai, Lithuania.
Jūratė AstravaitėMedical SPA Eglės sanatorija, Druskininkai, Lithuania.
Jovita JočienėGradiali Medical Spa & Wellness, Palanga, Lithuania.
Virmantas RinkevičiusHealth resort Draugystė, Druskininkai, Lithuania.
Antanas DanysHealth resort Versmė, Birštonas, Lithuania.
Liucija PatinskienėTulpės Sanatorium, Birštonas, Lithuania.
Nerijus KemeklisRecreation and health complex Atostogų parkas, Kretingos reg, Žibininkai, Lithuania.
Beatričė PargaliauskytėKlaipėda University, Klaipėda, Lithuania.
Dovydas RapolisVilnius University, Vilnius, Lithuania.
Justina RaulušonytėVilnius University, Vilnius, Lithuania.
Antonella FioravantiIndependent Researcher, Siena, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBalneotherapy (BT), involving the use of natural resources such as mineral water, peloids, and climate exposure, is increasingly recognized as a complementary intervention for stress-related mental health conditions. This study aimed to evaluate the short- and long-term effects of a standardized BT complex on stress, anxiety, depression, and related outcomes.

methodsA multicenter, randomized, controlled, single-blinded (researchers) parallel-group trial was conducted in six Lithuanian medical spa centers. Adults aged 18–65 years with moderate to high stress levels (N = 243) were randomized into three intervention groups—ambulatory BT (11ABT), ambulatory BT plus nature therapy (11ABTNT), inpatient BT (11BTS)—and one control group (11 C). The treatment period was 11 days, with assessments at baseline, post-intervention, 3 months, and 6 months. Primary outcomes included perceived stress (PSS-10), salivary cortisol, anxiety (STAI-5), and depression (CESD-R). Secondary outcomes were fatigue (FAS), sleep quality (SQS), functional adaptation (WSAS), integrative well-being, cognitive performance, and treatment safety.

resultsAll intervention groups showed statistically significant improvements across primary and secondary outcomes compared to baseline (p < 0.001), with medium to very large effect sizes. The greatest short-term effects were observed in the inpatient group (11BTS), including reductions of 46% in stress intensity, 54% in depression, and 49% in sleep impairment. Improvements in fatigue, anxiety, and stress management were also notable. These effects persisted at 6 months, with sustained reductions of up to 31% in stress, 27% in anxiety, and 50% in stress management. Sleep quality improved by up to 67%, and integrative outcomes by 40%. No serious adverse events were reported, and treatment was well-tolerated across all sites.

conclusionsBalneotherapy using natural resources is a safe, effective, and sustainable complementary approach for improving mental health. The observed reductions in stress, anxiety, depression, and fatigue—alongside enhanced sleep and functioning—suggest that BT may be a valuable addition to integrative care strategies for stress-related conditions. Further large-scale trials are warranted to confirm these findings and support wider clinical implementation.

trial registrationClinicalTrials.gov Identifier NCT06018649 (August 25th, 2023).

Indexed as

AnxietyBalneologyDepressionStress, PsychologicalAdolescentAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedSingle-Blind MethodYoung AdultAnxietyBalneotherapyComplementary medicineDepressionMental health promotionRandomized controlled trialStress reduction

Identifiers

PMID41845331
PMCPMC13107890

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.