Maternal Sleeping Problems Before and After Childbirth - A Systematic Review.

The perinatal and postpartum period is of great significance for women due to physiological changes, shifts in circadian rhythms, social setting, and psychological well-being, all of which affect the quality and quantity of their sleep. A mixed-studies systematic review was undertaken to enhance our understanding of sleep disturbances and mood disorders in women in late pregnancy and the postpartum period, their connection with breastfeeding, and the assessment of interventions for sleep disturbance. Three electronic databases (PUBMED, EMBASE and Google Scholar) were searched for qualitative, observational, and mixed-method studies from the year 2016 to June 2023. Twenty-nine articles were included in the analysis. The results were synthesized into four overarching themes: (і) the sleep quality of women in the perinatal period; (ii) the relationship between sleep and breastfeeding; (iii) the relationship between sleep quality and emotional disturbance in the perinatal period; (iv) sleep interventions in the researched group. The subjective nature of the perception of sleep disturbances, along with the absence of an objective measurement tool is clearly an inconvenience. It is advisable to include the assessment of maternal sleep hygiene and family sleep patterns during postpartum healthcare provider appointments to develop strategies not only for women's sleep quality but also for their mental well-being.

Pharmacological and Non-pharmacological Approaches for the Management of Neuropathic Pain in Multiple Sclerosis.

Multiple sclerosis is a chronic inflammatory disease that affects the central nervous system and can cause various types of pain including ongoing extremity pain, Lhermitte's phenomenon, trigeminal neuralgia, and mixed pain. Neuropathic pain is a major concern for individuals with multiple sclerosis as it is directly linked to myelin damage in the central nervous system and the management of neuropathic pain in multiple sclerosis is challenging as the options available have limited efficacy and can cause unpleasant side effects. The literature search was conducted across two databases, PubMed, and Google Scholar. Eligible studies included clinical trials, observational studies, meta-analyses, systematic reviews, and narrative reviews. The objective of this article is to provide an overview of literature on pharmacological and non-pharmacological strategies employed in the management of neuropathic pain in multiple sclerosis. Pharmacological options include cannabinoids, muscle relaxants (tizanidine, baclofen, dantrolene), anticonvulsants (benzodiazepines, gabapentin, phenytoin, carbamazepine, lamotrigine), antidepressants (duloxetine, venlafaxine, tricyclic antidepressants), opioids (naltrexone), and botulinum toxin variants, which have evidence from various clinical trials. Non-pharmacological approaches for trigeminal neuralgia may include neurosurgical methods. Non-invasive methods, physical therapy, and psychotherapy (cognitive behavioral therapy, acceptance and commitment therapy and mindfulness-based stress reduction) may be recommended for patients with neuropathic pain in multiple sclerosis. The choice of treatment depends on the severity and type of pain as well as other factors, such as patient preferences and comorbidities. There is a pressing need for healthcare professionals and researchers to prioritize the development of better strategies for managing multiple sclerosis-induced neuropathic pain.

Schizophrenia and disruption of circadian rhythms: An overview of genetic, metabolic and clinical signs.

A molecular clock in the suprachiasmatic nucleus of the anterior hypothalamus, which is entrained by the dark-light cycle and controls the sleep-wake cycle, regulates circadian rhythms. The risk of developing mental disorders, such as schizophrenia, has long been linked to sleep abnormalities. Additionally, a common aspect of mental disorders is sleep disturbance, which has a direct impact on the intensity of the symptoms and the quality of life of the patient. This relationship can be explained by gene alterations such as CLOCK in schizophrenia which are also important components of the physiological circadian rhythm. The function of dopamine and adenosine in circadian rhythm should also be noted, as these hypotheses are considered to be the most popular theories explaining schizophrenia pathogenesis. Therefore, determining the presence of a causal link between the two can be key to identifying new potential targets in schizophrenia therapy, which can open new avenues for clinical research as well as psychiatric care. We review circadian disruption in schizophrenia at the genetic, metabolic, and clinical levels. We summarize data about clock and clock-controlled genes' alterations, neurotransmitter systems' impairments, and association with chronotype in schizophrenia patients. Our findings demonstrate that in schizophrenia either homeostatic or circadian processes of sleep regulation are disturbed. Also, we found an insufficient number of studies aimed at studying the relationship between known biological phenomena of circadian disorders and clinical signs of schizophrenia.

Mental health and sleep disturbances among Ukrainian refugees in the context of Russian-Ukrainian war: A preliminary result from online-survey.

The ongoing Russian-Ukrainian conflict has caused a significant displacement of individuals, with an estimated five million Ukrainians seeking temporary refuge in other countries. We conducted a survey among Ukrainians in various countries worldwide using a convenience sample and analyzed 144 responses. The participants were divided into two groups: group 1, consisting of 92 Ukrainian refugees who were forced to leave their country due to the conflict, and group 2, comprising 52 individuals who did not change their place of residence. Data were collected through a structured online questionnaire consisting of socio-demographic questions, Depression, Anxiety, and Stress Scale-21, Insomnia Severity Index, and Symptom Checklist-90 during May-November 2022. We found that there were statistically significantly higher levels of obsessive-compulsive symptoms, depression, hostility, and overall distress in group 1. Group 1 had a higher risk of depression, anxiety, and stress, but not insomnia. In our study, refugee status, dissatisfaction with the state of health, job loss, suffering due to hostilities, and the received support from volunteers, friends, or relatives were the most important factors for the mental disorders. A bi-directional relationship was discovered between anxiety and insomnia, with both symptoms being associated with COVID-19 and subsequent psychiatric disorders. This study highlights the mental health and sleep problems faced by Ukrainian refugees as a result of the conflict linked to numerous social factors. Ukrainian refugees need social support programs and special attention to their mental health to facilitate their post-migration adaptation and integration into the host society.

Drug reprofiling history and potential therapies against Parkinson's disease.

Given the high whittling down rates, high costs, and moderate pace of new medication, revelation, and improvement, repurposing "old" drugs to treat typical and uncommon illnesses is progressively becoming an appealing proposition. Drug repurposing is the way toward utilizing existing medications in treating diseases other than the purposes they were initially designed for. Faced with scientific and economic challenges, the prospect of discovering new medication indications is enticing to the pharmaceutical sector. Medication repurposing can be used at various stages of drug development, although it has shown to be most promising when the drug has previously been tested for safety. We describe strategies of drug repurposing for Parkinson's disease, which is a neurodegenerative condition that primarily affects dopaminergic neurons in the substantia nigra. We also discuss the obstacles faced by the repurposing community and suggest new approaches to solve these challenges so that medicine repurposing can reach its full potential.

Melatonergic Receptors (Mt1/Mt2) as a Potential Additional Target of Novel Drugs for Depression.

A complex pathogenesis involving several physiological systems is theorized to underline the development of depressive disorders. Depression is accompanied by circadian regulation disruption and interaction with the functioning of both central and peripheral oscillators. Many aspects of melatonin function unite these systems. The use of drugs for circadian rhythm disorders could inspire a potential treatment strategy for depression. Melatonin plays an essential role in the regulation of circadian rhythms. It exerts effect by activating two types of melatonin receptors, type 1A (MT1) and 1B (MT2). These are G-protein-coupled receptors, predominantly located in the central nervous system. MT1/MT2 agonists could be a useful treatment approach according to all three prevalent theories of the pathogenesis of depression involving either monoamines, synaptic remodeling, or immune/inflammatory events. MT1/MT2 receptors can be a potential target for novel antidepressants with impact on concentrations of neurotrophins or neurotransmitters, and reducing levels of pro-inflammatory cytokines. There is an interesting cross-talk mediated via the physical association of melatonin and serotonin receptors into functional heteromers. The antidepressive and neurogenetic effects of MT1/MT2 agonists can also be caused by the inhibition of the acid sphingomyelinase, leading to reduced ceramide, or increasing monoamine oxidase A levels in the hippocampus. Compounds targeting MT1 and MT2 receptors could have potential for new anti-depressants that may improve the quality of therapeutic interventions in treating depression and relieving symptoms. In particular, a combined effect on MT1 and/or MT2 receptors and neurotransmitter systems may be useful, since the normalization of the circadian rhythm through the melatonergic system will probably contribute to improved treatment. In this review, we discuss melatonergic receptors as a potential additional target for novel drugs for depression.

Cognitive and affective disturbances in patients with Parkinson's disease: Perspectives for classifying of motor/neuropsychiatric subtypes.

Parkinson's disease (PD) is a neurological disorder, related to rigidity, bradykinesia, and resting tremors, among other motor symptoms. It is noticed in the increasing frequency of neuropsychiatric disorders, which may be also caused by non-motor symptoms of PD. Treatment of PD is usually based on the classification of motor subtypes; however, it remains unclear whether motor subtypes have differences in the severity of psychiatric symptoms. It determines the importance of discovering possible neuropsychiatric subtypes of PD. We conducted a clinical study, which included group 1 - patients with postural instability and gait disorders dominant (PIGD) subtype, group 2 - patients with tremor dominant (TD) and indeterminate subtypes (non-PIGD), and group 3 - people who did not have CNS damage. We used the Montreal Cognitive Assessment, Russified 20-point version of the Toronto Alexithymia Scale, State-Trait Anxiety Inventory, and Beck Depression Inventory for assessment of the mental status. It was the first time that neuropsychiatric subtypes of PD had been investigated based on the condition of cognition and mood. Cluster analysis gave us the possibility to classify our patients by the following subtype: affective-cognitive PIGD, anxious PIGD, affective-cognitive non-PIGD, and non-PIGD without psychiatric symptoms. This indicates a closed link between psychiatric and motor symptoms, which can be used for the improved treatment of PD.

Circadian rhythm disorder and anxiety as mental health complications in post-COVID-19.

In 2020, the world gained dramatic experience of the development of the 2019 coronavirus disease pandemic (COVID-19) caused by severe acute respiratory syndrome 2 (SARS-CoV-2). Recent researches notice an increasing prevalence of anxiety and circadian rhythm disorders during COVID-19 pandemic. The aim of the study was describing clinical features of circadian rhythm disorders and the level of anxiety in persons who have had COVID-19. We have conducted a cohort retrospective study that included 278 patients who were divided into 2 study groups according to medical history: group 1 includes patients with a history of COVID-19; group 2 consists of patients who did not have clinically confirmed COVID-19 and are therefore considered not to have had this disease. To objectify circadian rhythm disorders, they were verified in accordance with the criteria of the International Classification of Sleep Disorders-3. The level of anxiety was assessed by the State-Trait Anxiety Inventory. The most common circadian rhythm disorders were sleep phase shifts. We found that COVID-19 in the anamnesis caused a greater predisposition of patients to the development of circadian rhythm disorders, in particular delayed sleep phase disorder. In addition, it was found that after COVID-19 patients have increased levels of both trait and state anxiety. In our study, it was the first time that relationships between post-COVID-19 anxiety and circadian rhythm disorders had been indicated. Circadian rhythm disorders are associated with increased trait and state anxiety, which may indicate additional ways to correct post-COVID mental disorders and their comorbidity with sleep disorders.

Association between emotional-volitional dysfunction and features of aggression or hostility in mens with different forms of substance addictions: a cross-sectional study.

OBJECTIVE: The aim: The research aim was to study features of emotional-volitional sphere and its association in mens with different forms of Substance Addictions. PATIENTS AND METHODS: Materials and methods: We examined 146 patients with alcohol and drug addictions using Toronto Alexithymia Scale, Zverkov-Eidmann`s questionnaire and Buss-Durkee questionnaire. RESULTS: Results: The study showed an increase in the overall level of alexithymia, a moderate level of aggressiveness and a sufficient level of volitional self-regulation without a significant difference between the groups. The indirect correlation of "persistence" with the "general level of alexithymia", "difficulty identifying feelings" and "physical aggression" in group 1 and at the same time the indirect correlation between "self-control" and "verbal aggression" and "volitional self-regulation" with "difficulty describing feelings" can be explained by the opposite meaning of these concepts and phenomena themselves.However, it is interesting that the indicators "physical aggression" and "difficulty describing feelings" in group 2 were significantly lower, but at the same time correlated with "general level of alexithymia" and "irritability", respectively. On other hand in group 1 the indicator "suspiciousness" is directly related to the "general level of alexithymia", but its level is significantly lower in comparison with group 2. CONCLUSION: Conclusions: The phenomenon of alexithymia is not only recorded in the clinical picture of patients with various forms of addiction, but can also induce the development of manifestations of aggressiveness and hostility in them. Correction of alexithymia is necessary to understand the emotional state of these patients and choose the right approach to their treatment and rehabilitation.

Clinical and psychopathological characteristics of the autoagressive behavior in patients with the first psychotic episode with considering circadian rhythms.

INTRODUCTION: The high rate of autoagressive action in patients with psychotic symptoms manifested during the beginning of active psychopharmatherapy, and they are often the reason for psychiatric help. The continuous growth of autoagressive behavior indicates the number of unsolved problems in clinical suicidology. AIM: The aim of this research was to explore the clinical and psychopathological characteristics of the autoagressive behavior in patients with the first psychotic episode with considering circadian rhythms. MATERIAL AND METHODS: There was a research in regional clinical psychiatric hospital and 130 patients were involved in the research with autoagressive behavior during the first psychotic episodes. Clinical and psychopathological, psychodiagnostic and statistical methods were used. Characteristic clinical manifestations of first psychotic episode is determined by PANSS [1986] and BPRS [1962], level of suicidal risk is determined by Lyuban-Plotstsa's scale [2000], characteristics of biological rhythms is established by Estberg's questionnaire [1986]. RESULTS: Certain psychiatric symptoms were associated with the level of suicide risk in the first episode of psychosis, such as ≪tension", ≪hostility", ≪mannerisms and posturing, ≪excitement≫, ≪suspiciousness≫, ≪somatic concern≫, ≪anxiety≫, ≪depression≫, ≪guilt≫. Circadian rhythms include the level of risk occurrence and severity autoagressive behavior such as clearly and dimly expressed evening types of daily activity. CONCLUSIONS: Therefore, further research of autoagression during the first psychotic episode with considering the influence of biological rhythms is a given area of current research in psychiatry aimed to improve the prevention, treatment and rehabilitation.