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.

The human toll and humanitarian crisis of the Russia-Ukraine war: the first 162 days.

BACKGROUND: We examined the human toll and subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022. METHOD: We extracted and analysed data resulting from Russian military attacks on Ukrainians between 24 February and 4 August 2022. The data tracked direct deaths and injuries, damage to healthcare infrastructure and the impact on health, the destruction of residences, infrastructure, communication systems, and utility services - all of which disrupted the lives of Ukrainians. RESULTS: As of 4 August 2022, 5552 civilians were killed outright and 8513 injured in Ukraine as a result of Russian attacks. Local officials estimate as many as 24 328 people were also killed in mass atrocities, with Mariupol being the largest (n=22 000) such example. Aside from wide swaths of homes, schools, roads, and bridges destroyed, hospitals and health facilities from 21 cities across Ukraine came under attack. The disruption to water, gas, electricity, and internet services also extended to affect supplies of medications and other supplies owing to destroyed facilities or production that ceased due to the war. The data also show that Ukraine saw an increase in cases of HIV/AIDS, tuberculosis, and Coronavirus (COVID-19). CONCLUSIONS: The 2022 Russia-Ukraine War not only resulted in deaths and injuries but also impacted the lives and safety of Ukrainians through destruction of healthcare facilities and disrupted delivery of healthcare and supplies. The war is an ongoing humanitarian crisis given the continuing destruction of infrastructure and services that directly impact the well-being of human lives. The devastation, trauma and human cost of war will impact generations of Ukrainians to come.

BODY DYSMORPHOPHOBIC DISORDER AND OTHER NON-PSYCHOTIC MENTAL DISORDERS IN PERSONS WITH COSMETIC DEFECTS AND DEFORMITIES OF THE NOSE.

OBJECTIVE: The aim: To explore the features of non-psychotic mental disorders in people with cosmetic defects and deformities of the external nose in order to optimize their treatment and rehabilitation measures. PATIENTS AND METHODS: Material and methods: The authors examined 99 persons who reffered to a plastic surgeon for cosmetic rhinoplasty. The first group (Group I) included 30 individuals; they did not have cosmetic defects of the nose; however, these individuals fixed unreasonably great attention on the nose and persistently demanded to change its shape. The second group (Group II) included 69 individuals with visible defects and deformities of the external nose, which deviated from the established aesthetic norm, but did not distort the appearance and did not violate the physiological functions. A comprehensive clinical-anamnestic, clinical-psychopathological, psychodiagnostic and socio-demographic examination of patients was carried out. RESULTS: Results: Patients of Group I with dysmorphophobic disorder and without defects and deformities of the nose, who insisted on surgical correction, compared with persons of Group II with minimal defects and deformities, had a deeper severity of depressive symptoms and personal anxiety with a predominance of dysthymic character accentuation, low adaptability, complete intolerance of themselves and their appearance, a high level of emotional discomfort and internal control. CONCLUSION: Conclusions: It is necessary to improve a comprehensive system of psychotherapeutic measures in combination with pharmacotherapy, in order to reduce psychopathological symptoms, improve the level of psychosocial functioning of the patients and create the preconditions for decision to abandon surgery.

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.