Space missions: psychological and psychopathological issues.

Exploring space is one of the most attractive goals that humanity ever set, notwithstanding, there are some psychological and psychopathological risks that should be considered. Several studies identified some possible hazards of space travels and related physical and psychological consequences on astronauts. If some psychological reactions are obviously inherent to the characteristics of the spaceships (habitability, confinement, psychological, and interpersonal relationships), other (disturbances of sleep-wake cycle, personality changes, depression, anxiety, apathy, psychosomatic symptoms, neurovestibular problems, alterations in cognitive function, and sensory perception) represent a clear warning of possible central nervous system (CNS) alterations, possibly due to microgravity and cosmic radiation. Such conditions and eventual CNS changes might compromise the success of missions and the ability to cope with unexpected events and may lead to individual and long-term impairments. Therefore, further studies are needed, perhaps, requiring the birth of a novel branch of psychology/psychiatry that should not only consider the risks related to space exploration, but the implementation of targeted strategies to prevent them.

Mental Health and Neuropsychiatric Aftermath 35 Years After the Chernobyl Catastrophe: Current State and Future Perspectives.

OBJECTIVE: The Chernobyl nuclear power plant (ChNPP) disaster that happened in Ukraine on the 26th of April 1986 still represents the most severe nuclear accident in human history. Its consequences, especially those involving mental health are increasingly emerging as long-term detrimental effects. Therefore, the aim of the present paper was to review the results of some of authors' studies and their personal reflections on this topic. METHOD: The authors selected and commented on the findings mainly derived from their contributions on the prevalence of long-term psychopathological symptoms and neuropsychiatric disorders in diferent groups of exposed and non exposed individuals, including the workers at the NPP the so-called liquidators (CUWs), the most exposed group, evacuees and people living in more or less contaminated areas. RESULTS: The main findings derived from a series of studies carried out by the authors throughout the following decades after the disaster indicate the high prevalence of cerebrovascular diseases, organic mental and depressive disorders, cognitive impairment and even dementia that increase with the irradiation dose mainly amongst the liquidators. The organic disorders are probably related to a peculiar effect of radiation on left, dominant brain hemisphere. Interestingly, recent studies revealed abnormalities of the serotonin transporter and other genes disorders possibly at the basis of depression of exposed individuals. CONCLUSIONS: The high prevalence of neuropsychiatric disorders amongst irradiated subjects following the ChNPP disaster highlights the impact of radiation exposure on the lifelong onset of neuropsychiatric disorders, for too long neglected by international agencies. Such findings require to be deepened in the future possibly within the frame of the so-called "ecological psychiatry".

The impact of the early phase of the COVID-19 pandemic on mental-health services in Europe.

PURPOSE: The current COVID-19 pandemic confronts psychiatric patients and mental health services with unique and severe challenges. METHODS: In order to identify these trans-national challenges across Europe, an ad-hoc survey was conducted among 23 experts, each answering for one European or aligned country. RESULTS: A number of important themes and issues were raised for the impact of COVID-19 on mental health and mental health services, barriers to service provision and future consequences. A number of key issues were reported by colleagues across several jurisdictions, even though these were at different stages of their national epidemics. CONCLUSIONS: Based on these findings, we articulate some important learnings from the early stages of the COVID-19 European pandemic, and highlight key considerations for all countries' mental health services as the current pandemic develops and for future pandemics.

The Burden of Space Exploration on the Mental Health of Astronauts: A Narrative Review.

Space travel, a topic of global interest, has always been a fascinating matter, as its potential appears to be infinite. The development of advanced technologies has made it possible to achieve objectives previously considered dreams and to widen more and more the limits that the human species can overcome. The dangers that astronauts may face are not minimal, and the impacts on physical and mental health may be significant. Specifically, symptoms of emotional dysregulation, cognitive dysfunction, disruption of sleep-wake rhythms, visual phenomena and significant changes in body weight, along with morphological brain changes, are some of the most frequently reported occurrences during space missions. Given the renewed interest and investment on space explorations, the aim of this paper was thus to summarize the evidence of the currently available literature, and to offer an overview of the factors that might impair the psychological well-being and mental health of astronauts. To achieve the goal of this paper, the authors accessed some of the main databases of scientific literature and collected evidence from articles that successfully fulfilled the purpose of this work. The results of this review demonstrated how the psychological and psychiatric problems occurring during space missions are manifold and related to a multiplicity of variables, thus requiring further attention from the scientific community as new challenges lie ahead, and prevention of mental health of space travelers should be carefully considered.

Radiation-Induced Cerebro-Ophthalmic Effects in Humans.

Exposure to ionizing radiation (IR) could affect the human brain and eyes leading to both cognitive and visual impairments. The aim of this paper was to review and analyze the current literature, and to comment on the ensuing findings in the light of our personal contributions in this field. The review was carried out according to the PRISMA guidelines by searching PubMed, Scopus, Embase, PsycINFO and Google Scholar English papers published from January 2000 to January 2020. The results showed that prenatally or childhood-exposed individuals are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. In adulthood and medical/interventional radiologists, the most frequent IR-induced ophthalmic effects include cataracts, glaucoma, optic neuropathy, retinopathy and angiopathy, sometimes associated with specific neurocognitive deficits. According to available information that eye alterations may induce or may be associated with brain dysfunctions and vice versa, we propose to label this relationship "eye-brain axis", as well as to deepen the diagnosis of eye pathologies as early and easily obtainable markers of possible low dose IR-induced brain damage.

Depressive Syndromes Associated with Alcohol Dependence.

OBJECTIVE: Depressive syndromes (DSs) are some of the most common mental disorders in individuals suffering from alcohol dependence (AD). The aim of the study was to investigate the characteristics of DSs associated with AD in a group of inpatients admitted in a psychiatric hospital. METHOD: One hundred sixty inpatients between 25 and 58 years of age (mean ± SD: 37.30 ± 7.97), suffering from AD and DSs and recruited from a larger clinical sample, were included. They were evaluated by means of a battery of diagnostic/rating scales for assessment of both diagnosis and symptoms severity. RESULTS: Complete physical and psychiatric examinations of AD patients showed that DSs represent a very heterogeneous group that can be divided in: psychogenic (66.3%), endogenous (11.3%), organic (22.4%), and mixed. The following clinical depressive subtypes could be identified: hypochondriac (42.5%), asthenic (20.6%), agitated (19.4%), dysphoric (8.8%), simple (4.35%), and apathetic (4.35). CONCLUSIONS: Our study indicates that DSs during AD represent a constant association that frequently complicates the clinical pictures, induces low quality of life and personal adjustment, and impairs remission. Investigation of the casual and intertwined factors, developmental patterns and clinical structure of the AD-associated DSs should allow optimizing a tailored and integrated system of medical rehabilitation help.

Low dose or low dose rate ionizing radiation-induced health effect in the human.

The extensive literature review on human epidemiological studies suggests that low dose ionizing radiation (LDIR) (≤100 mSv) or low dose rate ionizing radiation (LDRIR) (<6mSv/H) exposure could induce either negative or positive health effects. These changes may depend on genetic background, age (prenatal day for embryo), sex, nature of radiation exposure, i.e., acute or chronic irradiation, radiation sources (such as atomic bomb attack, fallout from nuclear weapon test, nuclear power plant accidents, 60Co-contaminated building, space radiation, high background radiation, medical examinations or procedures) and radionuclide components and human epidemiological experimental designs. Epidemiological and clinical studies show that LDIR or LDRIR exposure may induce cancer, congenital abnormalities, cardiovascular and cerebrovascular diseases, cognitive and other neuropsychiatric disorders, cataracts and other eye and somatic pathology (endocrine, bronchopulmonary, digestive, etc). LDIR or LDRIR exposure may also reduce mutation and cancer mortality rates. So far, the mechanisms of LDIR- or LDRIR -induced health effect are poorly understood. Further extensive studies are still needed to clarify under what circumstances, LDIR or LDRIR exposure may induce positive or negative effects, which may facilitate development of new therapeutic approaches to prevent or treat the radiation-induced human diseases or enhance radiation-induced positive health effect.

Neuropsychiatric characteristics of antiterrorist operation combatants in the Donbass (Ukraine).

OBJECTIVE: The present paper aimed to explore the neuropsychiatric characteristics of the antiterrorism (ATO) combatants in the Donets Basin (Donbass) and to propose therapeutic strategies for managing their mental healthcare. METHODS: A total of 54 ATO combatants were included in our study and compared with four groups of subjects exposed to other emergencies, including the Chernobyl disaster and the war in Afghanistan. The neuropsychiatric features were assessed through psychopathological assessments, neurological examinations, and quantitative electroencephalography (qEEG). RESULTS: The ATO combatants were characterized by low health self-estimation, somatic concerns, a high prevalence of posttraumatic stress disorder, anxiety, insomnia, depression, social dysfunction, mild cognitive impairment, and neurological soft signs, similar to individuals involved in the Chernobyl disaster and veterans of the Afghan War. Quantitative EEG showed abnormalities suggestive of irritation of the corticolimbic system and diencephalic structures. Some post-conflict personality changes in ATO combatants were recorded. The treatment of ATO combatants included a comprehensive strategy: from psychotropic drugs to different psychotherapies. CONCLUSIONS: On the basis of 30 years of experience in the management of the consequences of Chernobyl disaster and the available studies on war veterans, the authors proposed a method for assessment and an approach to providing mental healthcare for ATO combatants, refugees, and migrants from the Donbass, which perhaps can be used as guidelines for other conflicts. Taken together, the findings of the study suggest that voluntary participation in war may decrease but does not eliminate the risk of developing the neuropsychiatric consequences caused by such conflicts. A comprehensive strategy-one that would encompass psychopharmacological, psychological, and rehabilitation techniques-seems to be the most successful approach to managing the main symptoms and disorders involved.

Cerebral basis of posttraumatic stress disorder following the Chernobyl disaster.

BACKGROUND: Whether posttraumatic stress disorder (PTSD) following radiation emergency has psychopathological, neurocognitive, and neurophysiological peculiarities is at issue. OBJECTIVE: The goal was to explore the features and cerebral basis of "radiation" PTSD in the survivors of the Chernobyl accident. Subjects and Methods The cross-sectional study included 241 people, 219 of whom have been diagnosed with PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria, among them 115 clean-up workers of the Chernobyl accident (34 with acute radiation sickness), 76 evacuees from the Chernobyl exclusion zone, 28 veterans of the war in Afghanistan, and 22 healthy unexposed individuals. Psychometric examinations, neurocognitive assessments, computerized electroencephalography, and cerebral vascular Doppler were used. RESULTS: "Radiation" PTSD includes "flashforward" phenomena and anticipating stress (projection of fear and danger to the future); somatoform disorders (depression, trait and state anxiety); and neurocognitive deficit (impaired memory and attention, auditory-verbal memory and learning, proactive and retroactive interference, cerebellar and stem symptoms, intellectual changes). The intima-media component, thickness of common carotid arteries, and common and left internal carotid arteries stenosis rates are increased in the liquidators. Changes of bioelectrical brain activity as a decrease of beta- and theta-power, together with an increase of alpha-power, were found in the Chernobyl accident survivors with PTSD. CONCLUSIONS: PTSD following radiation emergency is characterized by comorbidity of psychopathology, neurocognitive deficit, and cerebrovascular pathology with increased risk of cerebral atherosclerosis and stroke. The cerebral basis of this PTSD is proposed to be an abnormal communication between the pyramidal cells of the neocortex and the hippocampus, and deep brain structures. It is recommended that a system of emergency and long-term psychological and psychiatric care be organized for the survivors in Fukushima Daichi, Japan.

Disrupted development of the dominant hemisphere following prenatal irradiation.

One hundred children, exposed prenatally to radiation after the Chernobyl nuclear power plant accident, and 50 nonexposed classmates were examined between the ages of 11 and 13 years old using neuropsychiatric tests, WISC, EEG, and visual evoked potentials. Individual prenatal radiation doses were reconstructed for all examined children. The exposed children were found to have more neuropsychiatric disorders, left-brain neurological signs, lower full-scale and verbal IQ, IQ discrepancies with verbal decrement, disorganized EEG patterns, an excess of lateralized-to-left frontotemporal region delta and beta power with depression of theta and alpha power, and interhemispheric inversion visual information processing. Mothers' mental health, stress, and prenatal irradiation contributed to these effects, along with several confounding factors.

Whether ionizing radiation is a risk factor for schizophrenia spectrum disorders?

The neural diathesis-stressor hypothesis of schizophrenia, where neurobiological genetic predisposition to schizophrenia can be provoked by environmental stressors is considered as a model of the effects of exposure to ionizing radiation. Analysis of information from electronic databases (MEDLINE, PsycINFO, EMBASE, Current Contents, Elsevier BIOBASE) and hand-made search was carried out. There are comparable reports on increases in schizophrenia spectrum disorders following exposure to ionizing radiation as a result of atomic bombing, nuclear weapons testing, the Chernobyl accident, environmental contamination by radioactive waste, radiotherapy, and also in areas with high natural radioactive background. The results of experimental radioneurobiological studies support the hypothesis of schizophrenia as a neurodegenerative disease. Exposure to ionizing radiation causes brain damage with limbic (cortical-limbic) system dysfunction and impairment of informative processes at the molecular level that can trigger schizophrenia in predisposed individuals or cause schizophrenia-like disorders. It is supposed that ionizing radiation can be proposed as a risk factor for schizophrenia spectrum disorders. The hypothesis that ionizing radiation is a risk factor for schizophrenia spectrum disorders can be tested using data from the Chernobyl accident aftermath. Implementation of a study on schizophrenia spectrum disorders in Chernobyl accident victims is of significance for both clinical medicine and neuroscience.

EEG patterns in persons exposed to ionizing radiation as a result of the chernobyl accident. Part 2: quantitative EEG analysis in patients who had acute radiation sickness.

Cross-sectional quantitative electroencephalogram (qEEG) study (1996-2001) among Chernobyl accident survivors, who had confirmed acute radiation sickness and were irradiated in dose of 1-5 Gy, revealed the neurophysiological markers of ionizing radiation. Neuropsychological markers were: left fronto-temporal dominant frequency reduction; absolute delta-power lateralization to the left (dominant) hemisphere; relative delta-power increase in the fronto-temporal areas; absolute theta-power decrease in the left temporal region; absolute and relative alpha-power diffusive decrease, which may reflect cortico-limbic dysfunction lateralized to the left, dominant hemisphere, with the fronto-temporal cortical and hippocampal damage. Quantitative electroencephalogram proposed for differentiation of radiation and nonradiation brain damages and as a new biological dosymetry method. High radiosensitivity of the brain, neocortex, and dominant hemisphere higher radiosensitivity are discussed.