HRM  treatment is associated with clinical improvement in diseases of the skin , respiratory , circulatory , digestive and nervous system among others .
The scientific literature of the last decade has shown that a number of non-musculoskeletal disorders are treated with different kinds of  HRM .
Health resort medicine ( HRM ; in German : Kurortmedizin ) is a field of medicine with long-lasting tradition in several European countries .
A number of systematic review s have shown the effectiveness of HRM  in musculoskeletal conditions .
Review s focusing on the effectiveness of HRM in non-musculoskeletal disorders are rare .
This systematic review aims to provide an overview about all types of health resort treatments applied in non-musculoskeletal conditions , to summarize evidence for its effectiveness and to assess the quality of published studies .
Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder.
INTRODUCTION Preliminary studies have suggested that balneotherapy ( BT ) is an effective and well-tolerated treatment for  generalized anxiety disorder ( GAD ) and psychotropic medication withdrawal syndrome .  We carried out a study in 4 spa resorts to assess the efficacy of BT in GAD . METHOD We compared BT to paroxetine in terms of efficacy and safety in a r and omized multicentre study lasting 8 weeks . Patients meeting the diagnostic criteria of GAD ( DSM-IV ) were recruited . Assessment s were conducted using the Hamilton Rating Scale for Anxiety ( HAM-A ) and other scales , by a specifically trained and independent physician . The primary outcome measure was the change in the total HAM-A score between baseline and week 8 . RESULTS A total of 237 out patients were enrolled in four centres ; 117 were assigned r and omly to BT and 120 to paroxetine .  The mean change in HAM-A scores showed an improvement in both groups with a significant advantage of BT compared to paroxetine ( -12.0 vs -8.7 ; p<0.001 ) . Remission and sustained response rates were also significantly higher in the BT group ( respectively 19 % vs 7 % and 51 % vs 28 % ) . CONCLUSION BT is an interesting way of treating GAD . Due to its safety profile it could also be tested in resistant forms of generalized anxiety and in patients who do not tolerate or are reluctant to use pharmacotherapies
HRM  treatment is associated with clinical improvement in diseases of the skin , respiratory , circulatory , digestive and nervous system among others .
The scientific literature of the last decade has shown that a number of non-musculoskeletal disorders are treated with different kinds of  HRM .
Health resort medicine ( HRM ; in German : Kurortmedizin ) is a field of medicine with long-lasting tradition in several European countries .
A number of systematic review s have shown the effectiveness of HRM  in musculoskeletal conditions .
Review s focusing on the effectiveness of HRM in non-musculoskeletal disorders are rare .
This systematic review aims to provide an overview about all types of health resort treatments applied in non-musculoskeletal conditions , to summarize evidence for its effectiveness and to assess the quality of published studies .