Maintaining the mental health of Ukrainians in time of war: searching for a mechanism to provide a comprehensive system of psychosocial support and mental health awareness.

OBJECTIVE: Aim: To substantiate the possibilities of developing a comprehensive system of psychosocial support for Ukrainians during and after the war through thedevelopment of an integrated model of psychosocial service provision in the community, which promotes cross-sectoral interaction and expands the possibilities of integrating and scaling up multiple levels of mental health interventions. PATIENTS AND METHODS: Materials and Methods: The article is based on the use of bibliosemantic analysis of scientific works on the topic of mental health and mental health during the war. CONCLUSION: Conclusions: It is emphasised that in developing a comprehensive system of psychosocial support, it is necessary to: ensure accessibility of services for those in need; integrate services into the general health and social protection system; use a multisectoral approach, involving various organisations, institutions and professionals; train professionals to work in war conditions; develop and implement psychoeducation and psychological support programmes; monitor and evaluate the effectiveness of programmes. Particular attention is paid to psychoeducation as a technology that can be used at different levels of psychological intervention by both mental health professionals and other specialists involved in the provision of social services in communities. The spread of the impact of psychoeducational programmes will contribute to the development of community resilience in the face of social and psychological risks provoked by the war. A mechanism for scaling up the capabilities of the Technical Working Group on Mental Health and Psychosocial Support (MHPSS TWG), an association of leading international and Ukrainian NGOs specialising in mental health, established in Ukraine with the support of the WHO and the Ministry of Health of Ukraine, is proposed. The idea of creating a network of Resilience Centres in communities with the aim of forming a comprehensive system of psychosocial support at the state and community levels is substantiated.

MANIFESTATIONS OF EXCESSIVE DAYTIME SLEEPINESS AND GHRELIN LEVEL IN CASE OF GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH UNDIFFERENTIATED CONNECTIVE TISSUE DISEASE.

OBJECTIVE: The aim of the study was to discover the interrelation between the severity of gastroesophageal reflux disease (GERD) symptoms, acid exposure time (AET), excessive daytime sleepiness (EDS) and the level of active blood plasma ghrelin in the patients with undifferentiated connective tissue disease (UCTD). PATIENTS AND METHODS: Materials and methods: The study included 120 patients with GERD. All the patients were divided in two groups: Group I - GERD was not accompanied by the signs of connective tissue disease (n=45) and Group II - GERD developed on the background of UCTD syndrome (n=75). Daily transnasal pH monitoring was performed to determine the nature of pathological refluxes. EDS was detected by The Epworth Sleepiness Scale. Active ghrelin in blood plasma samples was determined by ELISA. RESULTS: Results: 80% of the patients of Group II and 35.48% of Group I suffered from EDS (p<0.05). The mean daily AET index was 5.48±0.4% in Group II and 6±0.2% in Group I, in the night hours mostly when patients were in the upright position. This phenomenon contributed to a deterioration of sleep quality and the appearance of EDS and was supported by a connection between AET and EDS (r=+0.827 for Group I and r=+0.768 for Group II). The mean De Meester index was higher in the patients of Group II (23.01±2.24 in Group I vs 31.08±2.4 in Group II; p<0.05). CONCLUSION: Conclusions: GERD manifestations are strongly related to the level to AET and intensity of EDS. The EDS symptoms depend on circulating ghrelin level.