{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:21:03Z","timestamp":1783405263635,"version":"3.54.6"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pediatric-psychosomatic inpatient therapy is an essential part of the German health care system for the treatment of mental disorders in children and adolescents. However, empirical research in this field remains scarce and limited to psychological parameters. This longitudinal naturalistic study aimed to evaluate the efficacy and sustainability of inpatient psychosomatic therapy in children and adolescents by examining both psychological outcomes and biological markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 58 patients were assessed at seven time points before, during, and after treatment. Hair cortisol concentration (HCC) was measured as a neuroendocrine parameter of long-term stress regulation. Psychometric data were collected using five validated questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings indicated significant improvements in perceived stress, depressive and anxiety symptoms, family functioning and internalizing symptoms in the course of inpatient treatment. Overall, these effects remained stable at three- and six-month follow-ups, with only transient increases in depressive symptoms and family problems. HCC showed a significant decrease from admission to discharge and remained stable across follow-ups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These results support the efficacy of inpatient pediatric psychosomatic interventions on both psychological outcomes and neuroendocrine stress regulation and highlight the value of integrating biological markers into psychotherapy research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1867478","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:47:17Z","timestamp":1783403237000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hair cortisol as psychotherapy process parameter \u2013 an inpatient pediatric psychosomatic 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