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7 кроків до відновлення після коронавірусної хвороби (COVID-19) : методичні рекомендації для пацієнтів
(ПП Пасинога О.М., 2021) Бойко, Дмитро Миколайович; Бойко, Оксана Сергіївна; Boiko, D. I.; Boiko, O. S.
Методичні рекомендації для пацієнтів розроблені на основі досвіду передових наукових практик. У них репрезентовані базові принципи поетапного відновлення після перенесеної коронавірусної хвороби (COVID-19) різного ступеня тяжкості.
Affective syndromes in adults with chronic low back pain
(Medicinska Naklada Zagreb, 2023) Mats, O. V.; Kachala, V. V.; Kachur, R. V.; Boiko, D. I.; Zhyvotovska, L. V.; Мац, Оксана Василівна; Качала, Вероніка Володимирівна; Качур, Роман Володимирович; Бойко, Дмитро Іванович; Животовська, Лілія Валентинівна
Low back pain can have as organic or non-specific, as psychological etiology. It is known that psychological factors have some relationship with adjustment to persistent pain, that is factors leading to increased/worse or decreased/improved adjustment to back pain. We conducted a case-control study in the Communal Enterprise “1st City Clinical Hospital of the Poltava City Council” during October-January 2021. The study included 19 people with complaints of neuropathic pain in the lower back who were divided into 2 groups: group 1 included 18 people with neuropathic pain; group 2 included 21 people with nonspecific pain. Patients suffering from low back pain have different severity of affective symptoms depending on its type. Neuropathic pain may be associated with higher depression due to higher severity, which should be noted in the choosing of treatment approaches.
Alexithymia in healthy people and its role in development of different disorders
(Українська медична стоматологічна академія, 2019) Skrypnikov, A. M.; Zhyvotovska, L. V.; Herasymenko, L. O.; Boiko, D. I.; Bodnar, L. A.; Скрипніков, Андрій Миколайович; Животовська, Лілія Валентинівна; Герасименко, Лариса Олександрівна; Бойко, Дмитро Іванович; Боднар, Леся Анатоліївна
Знижену здатність або ускладненість усно висловити, назвати власні емоційні стани або почуття інших людей,прийнято називати алекситимією. В даний час проводяться дослідження, в яких з'ясовують, чи є алекситимія специфічною властивістю особистості або ж вона може призводити до психосоматичних захворювань, будучи їх предиктором. Деякі дослідники вважають, що алекситимія сама по собі не є захворюванням і являє собою ряд характеристик, властивих певним індивідам. Алекситимія чітко виражена в складі особистості пацієнтів із серцевосудинними захворюваннями і являє собою окремий фактор в цій структурі. В цілому дослідження показують, що пацієнти з алекситимією гіперчутливі як до внутрішніх соматичних неприємних відчуттів, так і до зовнішніх больових стимулів, проте описати відмінності різних видів болю у них не виходить. Алекситимію можна розглядати як один з преморбідних особистісних факторів, що знижують компенсаторні можливості психологічного захисту при люцидному алкоголізмі. Алекситимія виявлена у багатьох пацієнтів з наркоманіями. Замість того, щоб просто звільнитися від болісних, нестерпних або гнітючих почуттів, люди, які зловживають хімічними речовинами, можуть використовувати їх для управління афектами, особливо коли ці афекти виявляється важко вловити, розрізнити і дати їм назву. У той же час недостатньо вивчені відмінності в проявах алекситимії при алкогольних і наркотичних залежностях, в тому числі її вплив на розвиток залежної поведінки. Вивчення алекситимії є актуальним питанням сучасної психіатрії та наркології, оскільки дозволить застосовувати персоніфікований підхід до пацієнта та вдосконалити сучасні лікувально-реабілітаційні заходи.
Association between emotional-volitional dysfunction and features of aggression or hostility in mens with different forms of substance addictions: a cross-sectional study
(Aluna Publishing, 2020) Zhyvotovska, L. V.; Boiko, D. I.; Kadzhaia, N. V.; Shkodina, A. D.; Demianenko, I. V.; Borysenko, V. V.; Животовська, Лілія Валентинівна; Бойко, Дмитро Іванович; Шкодіна, Анастасія Дмитрівна; Борисенко, Володимир Васильович
The aim: The research aim was to study features of emotional-volitional sphere and its association in mens with different forms of Substance Addictions. 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: 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. 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.
Challenges and Gaps in the Treatment of Advanced Sleep Phase Disorder: A Call for Further Research and Understanding
(University of Niš, 2024) Boiko, D. I.; Mats, O. V.; Shkodina, A. D.; Skrypnikov, A. M.; Бойко, Дмитро Іванович; Мац, Оксана Василівна; Шкодіна, Анастасія Дмитрівна; Скрипніков, Андрій Миколайович
People with circadian rhythm disturbances are at an elevated risk of mental disorders, and conversely, those with mental disorders are more susceptible to the circadian disruption. A steady circadian cycle of sleep and wakefulness that is phase-shifted relative to the prior local solar time may be characterized by a short endogenous circadian period. Advanced sleep-wake phase disorder (ASPD) is characterized by a substantial advancement of the sleep-wake cycle phase, followed with sleep-related symptoms. ASPD is a challenging sleep-wake disorder to manage, with current treatment options varying in efficacy and potential side effects. Further research is needed to identify effective treatment options and to elucidate the underlying mechanisms of ASPD. More research is needed to better understand the underlying mechanisms of ASPD and the molecular and metabolic changes associated with aging that may contribute to the development of the disorder.
Circadian rhythm disorder and anxiety as mental health complications in post‑COVID‑19
(Springer, 2022) Boiko, D. I.; Skrypnikov, A. M.; Shkodina, A. D.; Hasan, M. M.; Ashraf, G. M.; Rahman, M. H.; Бойко, Дмитро Іванович; Скрипніков, Андрій Миколайович; Шкодіна, Анастасія Дмитрівна
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 confrmed COVID-19 and are therefore considered not to have had this disease. To objectify circadian rhythm disorders, they were verifed in accordance with the criteria of the International Classifcation 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 frst 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.
Clinical features of anxiety disorder in post-COVID-19 syndrome and finding of its predictors
(Національний університет ім. О. О. Богомольця, 2021-12-26) Boiko, D. I.; Бойко, Дмитро Іванович
The article summarizes and describes clinical features of anxiety disorders in post-COVID-19 syndrome. Mental and neurological disorders occupy a leading place in the structure of post-COVID syndrome. Recent studies indicate an increase in the incidence of anxiety disorders in individuals with COVID-19. However, no clini-cal or laboratory features of the post-COVID anxiety disorders have been identified. Therefore, our study aimed to describe the clinical features of anxiety disorders in the post-COVID period and to develop a mathematical prog-nostic model to identify potential predictors of post-COVID anxiety disorder. We conducted a case-control clinical study, which included 145 males and females, which were divided into 2 groups, namely: group 1 - patients who became ill with COVID-19 during the last 6 months and group 2 - persons who were not ill with COVID-19 during the last 6 months. The clinical interview included the registration of symptoms of the debut and the time of the debut relative to the episode of COVID-19. The Beck anxiety inventory was used for the assessment of the overall level of anxiety. The State-trait anxiety inventory was used to assess state and trait anxiety. Statistical analysis of the data was performed using the program EZR Statistics 1.54. Anxiety disorders during the first 6 months after COVID-19 develop more often than those who have not had the disease in the last six months. Patients who had COVID-19 in the last 5-24 weeks have an increased risk of anxiety disorders during this period and therefore require close medical supervision and sufficient awareness of the likely symptoms. People with a post-COVID anxiety disorder reported the presence of autonomic symptoms, including excessive sweating and tachycardia, a feeling of inner emptiness, as well as circadian rhythm disorders in the form of difficulty falling asleep and waking up at the desired time. It should be noted that the overall frequency of detection of anxiety disorders in the post-COVID period is increasing. It has been established that the risk of developing post-COVID disorder decreases with knowledge of the fact of contact with an infected person before the COVID onset and increases with a heightened level of prior personal anxiety. Circadian rhythm disorders, in particular sleep phase shift and abnormal fatigue, may be predic-tors of post-COVID anxiety disorder.
Cучасні підходи до фармакотерапії посттравматичного стресового розладу
(Українська медична стоматологічна академія, 2019) Животовська, Лілія Валентинівна; Бойко, Дмитро Іванович; Сокіл, Антон Андрійович; Погорілко, Олег Володимирович; Волошин, Віктор Анатолійович; Животовская, Лилия Валентиновна; Бойко, Дмитрий Иванович; Сокол, Антон Андреевич; Погорелко, Олег Владимирович; Волошин, Виктор Анатольевич; Zhyvotovska, L. V.; Boiko, D. I.; Sokil, A. A.; Pogorilko, O. V.; Voloshyn, V. A.
У дослідженні розглянуті сучасні тенденції розвитку психофармакології посттравматичного стресового розладу з використанням MДMA, D-циклосерина, канабідіола, кетаміна та нейропептида Y. При лікуванні ПТСР перевага надається психотерапії, тоді як фармакотерапія розглядається як вторинна. В даний момент розглядається можливість використання вищезазначених речовин як у складі комплексної, так і комбінованої терапії з огляду на їх нейробіологічні ефекти, які, в свою чергу, впливають на різні ланки біохімічних процесів реконсолідації пам’яті. Так дослідження у здорових людей показали, що МДМА опосередковує обробку емоційної пам’яті. DCS впливає на специфічні підтипи рецепторів NMDA, однією з функцій яких є модуляція відповіді на екстинцію страху. Заслуговує на увагу збереження потенціалу нейропластичності та стимуляція глутаматергічної системи кетаміном у якості нового напряму фармакотерапії ПТСР. Нині на доклінічному етапі перебувають лікарські препарати, що використовують NPY-рецептори у якості терапевтичних мішеней. Незважаючи на цілу низку отриманих позитивних результатів, багато питань у цій сфері залишаються нерозв’язаними та вимагають подальшого опрацювання та поглибленого вивчення.
Healthcare system amidst the war in Ukraine
(Elsevier, 2022) Shkodina, A. D.; Chopra, H.; Singh, I.; Shoaib, A.; Boiko, D. I.
For more than two months now, Russian troops have been destroying cities in Ukraine. On February 24, 2022, Russia unreasonably attacked Ukraine. The bloody conflict in Ukraine has seen several attacks on healthcare institutions, including hospitals and clinics. Healthcare is a significant force, especially in the context of military conflict. Not only because it takes care of wounded combatants, but also because it allows the society to continue to function before, during, and after the war. The healthcare system in Ukraine is facing the terrible challenges of war and needs humanitarian aid and the support of the international community.
Increased subsequent risk of mental disorders after experienced stress-related disorders: correspondence
(Elsevier, 2023) Boiko, D. I.; Shkodina, A. D.; Бойко, Дмитро Іванович; Шкодіна, Анастасія Дмитрівна
Based on multiple studies, we emphasize isolated findings regarding the long-term implications of stress-related mental diseases, particularly alterations in the neurological, immunological, and endocrine systems’ homeostasis, as well as an increased risk of occurring other psychiatric disorders. Thus, despite substantial theoretical evidence, the mechanism and duration of alterations caused by stress-related disorders remain unexplained. Because the number of factors that can act as traumatic factors and lead to the development of stress-related disorders is increasing in the modern world, we should pay attention not only to the relief of acute symptoms of the disease but also to the evaluation of its prognosis and long-term consequences for improving global health.
Psychoeducational training for reducing the impact of a COVID-19 pandemic on healthcare workers
(University of Nis, Faculty of Medicine, 2023) Boiko, D. I.; Mats, O. V.; Zhyvotovska, L. V.; Herasymenko, L. O.; Skrypnikov, A. M.; Бойко, Дмитро Іванович; Мац, Оксана Василівна; Животовська, Лілія Валентинівна; Герасименко, Лариса Олександрівна; Скрипніков, Андрій Миколайович
Introduction. Healthcare workers are increasingly exposed to long-term traumatic events in the context of the COVID-19 pandemic. Methods. We conducted a study that included 100 healthcare workers and 50 healthy individuals. We used the Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Global Patient Impression for Improvement in the assessment of the psychological condition of respondents. To improve the psychoemotional state of health care workers, we proposed a program of psychoeducational training that was conducted at the workplace. After it, we reassessed the level of perceived stress, anxiety, and depression. Results. During the COVID-19 pandemic, in healthcare workers, the level of stress and anxiety was higher than in non-medical specialties, and the level of depression was not significantly different. The reduction of stress and anxiety was found. The subjective assessment of the improvement of the general condition indicates its positive dynamics after the psychoeducational training in both doctors and nurses. Conclusion. We showed the effectiveness of the proposed psychoeducational methodology for improving the psycho-emotional condition of healthcare workers during the COVID-19 pandemic.
Schizophrenia and disruption of circadian rhythms: An overview of genetic, metabolic and clinical signs
(Elsevier, 2024) Boiko, D. I.; Chopra, Hitesh; Bilal, Muhammad; Kydon, P. V.; Herasymenko, L. O.; Rud, V. O.; Bodnar, L. A.; Vasylyeva, G. Yu.; Isakov, R. I.; Zhyvotovska, L. V.; Mehta, Aashna; Skrypnikov, A. M.; Бойко, Дмитро Іванович; Кидонь, Павло Володимирович; Герасименко, Лариса Олександрівна; Рудь, Вадим Олексійович; Боднар, Леся Анатоліївна; Васильєва, Ганна Юріївна; Ісаков, Рустам Ісроїлович; Животовська, Лілія Валентинівна; Скрипніков, Андрій Миколайович
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.
Sleep and armed conflict: future complications of war in Ukraine
(Elsevier, 2022) Shkodina, A. D.; Zhyvotovska, A. I.; Boiko, D. I.; Шкодіна, Анастасія Дмитрівна; Животовська, Анастасія Ігорівна; Бойко, Дмитро Іванович
Sleep problems in combatants with posttraumatic stress disorder and its acceptance
(Полтавський державний медичний університет, 2024) Boiko, D. I.; Бойко, Дмитро Іванович
Протягом десятиліть проблеми зі сном набувають все більшої поширеності серед військовослужбовців. Поряд з цим участь в активних бойових діях сприяє розвитку стрес-асоційованих психічних розладів, які можуть супроводжуватися порушеннями сну. Однак в медицині сну не було достеменно вивчено роль прийняття проблем зі сном. Поряд з цим на сьогодні не було вивчено рівень прийняття проблем зі сном у комбатантів, а також його відмінностей за умови наявності ПТСР. Нами проведено клінічне дослідження 45 комбатантів, яких було розподілено на 2 групи: група 1 (n=24) – комбатанти з ПТСР; група 2 (n=21) – комбатанти без ПТСР. У пацієнтів було зібрано скарги на порушення сну, проаналізовано якість сну за допомогою Пітсбургського опитувальника якості сну та визначено рівень прийняття згідно з опитувальником прийняття проблем зі сном. Встановлено переважання скарг на кошмари та труднощі із засинанням серед пацієнтів групи 1 (р<0,001 та р=0,027 відповідно). Нами встановлено, що серед учасників групи 1 погана якість сну зустрічалася статистично значуще частіше (р<0,001). Пацієнти групи 1 мали нижчий рівень залученості до активності (р=0,023) і знижений рівень прийняття проблем зі сном порівняно з групою 2 (р=0,017). Таким чином нами продемонстровано, що комбатанти мають значні проблеми зі сном та високу частоту поганої якості сну. Серед скарг на проблеми зі сном незалежно від ПТСР у комбатантів найчастіше відмічаються недостатньо відновлювальний сон та часті пробудження. При ПТСР у комбатантів спостерігається більша частота скарг на труднощі із засинанням та кошмари, а також нижчий рівень прийняття проблем зі сном, зокрема залученості до активності, що доцільно враховувати при розробці стратегії лікування та виборі психотерапевтичного підходу. For decades, sleep problems have become increasingly common among military personnel. Along with this, participation in active hostilities contributes to the development of stress-associated mental disorders, which sleep disturbances may accompany. However, sleep medicine has not thoroughly studied the role of acceptance of sleep problems. Along with this, the level of acceptance of sleep problems among combatants, as well as its differences in the presence of PTSD, has not been studied to date. We conducted a clinical study of 45 combatants, who were divided into two groups: group 1 (n=24) – combatants with PTSD; group 2 (n=21) – combatants without PTSD. Patients ‘ complaints about sleep disturbances were collected, sleep quality was analyzed using the Pittsburgh Sleep Quality Questionnaire, and acceptance level was determined according to the Sleep Problems Acceptance Questionnaire. The predominance of complaints about nightmares and difficulty falling asleep among patients of group 1 was established (p<0.001 and p=0.027, respectively). We found that among the participants of group 1, poor sleep quality occurred statistically significantly more often (p<0.001). Group 1 patients had a lower level of activity involvement (p=0.023) and a reduced level of acceptance of sleep problems compared to group 2 (p=0.017). Thus, we demonstrated that combatants have significant sleep problems and a high frequency of poor sleep quality. Among the complaints of sleep problems independent of PTSD in combatants, insufficiently restorative sleep and frequent awakenings are most often noted. With PTSD, combatants have a higher frequency of complaints of difficulty falling asleep and nightmares, as well as a lower level of acceptance of sleep problems, in particular, involvement in activities, which should be taken into account when developing a treatment strategy and choosing a psychotherapeutic approach.
State of the autonomous nervous system and stress at outpatient appointment of dental-surgeon's patients with syncopathic conditions
(Полтавський державний медичний університет, 2023) Mamai, O. V.; Bilash, S. M.; Boiko, D. I.; Svyryda, O. S.; Oleksiienko, V. V.; Kopytko, N. S.; Kolomiiets, S. V.; Мамай, Олександр Володимирович; Білаш, Сергій Михайлович; Бойко, Дмитро Іванович; Свирида, Олександр Сергійович; Олексієнко, Владислав Віталійович; Копитько, Назар Станіславович; Коломієць, Світлана Веніамінівна
t. In clinical practice, a dental surgeon encounters a wide range of emergencies, including epileptic seizures, cardiac arrest, fainting (or syncope), and others. At the same time, syncope is often overlooked against the background of more severe and dangerous conditions. The aim is to assess the level of perceived stress and the state of the autonomic nervous system in outpatients of a dental surgeon at the beginning of the appointment, depending on the further development of syncope. We conducted a pilot prospective study that included 33 outpatients of a dental surgeon, who were divided into 2 groups: group 1 – patients who developed syncope (n=11); group 2 – patients who did not develop syncope during the visit to the clinic (n=22). During the medical history, patients were asked to complete a questionnaire to assess perceived stress (PSS-10). Every patient received a hemodynamic assessment that included measuring their blood pressure and pulse, determining the Kerdo Index, and examining their autonomic nervous system by checking for demographism. The amount of time spent in the queue was also documented. If a patient fainted, emergency care was immediately given.There were no significant differences in gender, age, diagnosis, or wait time between patients in both groups. There were no statistically significant differences between the groups of patients in terms of perceived stress. A statistically significant higher Kerdo index was found in group 1 with a tendency to sympathicotonia. Conclusions. Thus, we have determined that it is the increased activity of the sympathetic nervous system before an outpatient visit to a dental surgeon, rather than the subjective level of perceived stress, that may be potentially associated with the likelihood of developing syncope, which requires more detailed research. Although syncopal states are generally considered benign, frequent episodes of syncope can harm the patient’s quality of life, morbidity, and compliance with the dentist. Therefore, for safe dental treatment, dentists need to know the state of the autonomic nervous system before treatment to ensure a better therapeutic alliance and treatment outcomes
The combined influence of anxiety and COVID-19 on sleep quality and insomnia severity
(Wiley-Blackwell Publishing Ltd, 2022-09) Boiko, D. I.; Zhyvotovska, A. I.; Skrypnikov, A. M.; Sonnik, G. T.; Бойко, Дмитро Іванович; Животовська, Анастасія Ігорівна; Скрипніков, Андрій Миколайович; Сонник, Григорій Трохимович
Based on recent studies, we put forward a hypothesis about the synergistic effect of anxiety disorders and previous COVID-19 on the deterioration of the quality of sleep and the occurrence of insomnia. The objective was to investigate the impacts of anxiety disorders, COVID-19 in anamnesis, and its combined effect on sleep disturbances.
The influence of anxiety level and past COVID-19 on sleep quality and insomnia severity
(2022) Boiko, D. I.; Zhyvotovska, A. I.; Skrypnikov, A. M.; Бойко, Дмитро Іванович; Животовська, Лілія Валентинівна; Скрипніков, Андрій Миколайович
Based on recent studies, we put forward a hypothesis about the synergistic effect of anxiety disorders and previous COVID-19 on the deterioration of the quality of sleep and occurring of insomnia. The purpose of the study was to investigate the impacts of anxiety disorders, and COVID-19 on anamnesis and its combined effect on sleep disturbances. We conducted a case-control study, which included 60 patients, who were divided into 3 groups depending on the occurrence of anxiety disorders and COVID-19 in their medical history during the last 6 months. Patients were assessed by the Beck anxiety inventory, Pittsburgh Sleep Quality Index, and the Insomnia Severity Index. We found a worsening sleep quality and a higher frequency of insomnia in patients with COVID-19. Along with this, concomitant anxiety disorders worsened both the quality of sleep and the level of insomnia in these respondents. It was determined that patients with an anxiety disorder with a history had a lower subjective assessment of sleep quality, higher sleep latency, and more pronounced diurnal dysfunction, while patients without a history had better sleep efficiency and a lower frequency of sleeping pills. Anxiety disorders and having experienced COVID-19 are associated with poorer sleep quality and more severe insomnia. Their combination significantly reduces the quality of sleep and increases the degree of insomnia. These findings suggest a potential role for COVID-19 in exacerbating the association between anxiety and sleep disorders.
The mediating role of poor sleep quality in the relationship between posttraumatic stress disorder and aggression in combatants
(Полтавський державний медичний університет, 2024) Boiko, D. I.; Zhyvotovska, L. V.; Chopra, H.; Бойко, Дмитро Іванович; Животовська, Лілія Валентинівна; Чопра, Хітеш
Introduction. Stress-related mental disorders pose a significant risk to a patient's social, emotional, and physical well-being. One of the most vulnerable categories of the population to the development of stress-related mental disorders, including post-traumatic stress disorder, in wartime is military personnel who are constantly faced with events that threaten their lives and health. The most common complaints of combatants with PTSD include sleep disturbances and aggression. Therefore, we hypothesized that poor sleep quality may mediate the association between PTSD and aggression in combat veterans. Methods and materials. We conducted a clinical study of 45 combatants, who were divided into the following groups: group 1 (n=24) – combatants with PTSD, and group 2 (n=21) – combatants without stress-related mental disorders. We measured sleep quality by the Pittsburgh Sleep Quality Index and aggression by the Buss-Perry Aggression Questionnaire. Statistical analysis was performed using Jamovi Desktop. The mediation analysis was performed using the medmod 1.1.0 and advanced mediation models 1.0.5. Results. We found a strong statistically significant effect of PTSD on physical aggression (p<0.001). However, the mediating role of sleep was not found (p=0.264), as the effect of sleep disturbance on physical aggression was not confirmed (p=0.257), despite the strong effect of PTSD on sleep disturbance (p<0.001). It was found that the indirect effect of mediation through poor sleep quality accounted for 74.1% of the mediation of the relationship between PTSD and hostility. We established a partial mediation of the relationship between PTSD and aggressiveness by poor sleep quality. The direct effect accounts for 47.6% of the mediation, and the indirect effect through sleep disturbances accounts for 52.4%, which confirms the role of poor sleep quality as a mediator in this model. Concluions. Our findings emphasize that sleep disturbance is a significant symptom of PTSD that can affect other aspects of the disease in combatants. In this study, we demonstrate that poor sleep quality mediates hostility fully and general aggression partially in combatants with PTSD.
Аутоагресивна поведінка при першому психотичному епізоді : монографія
(Полтавський університет економіки і торгівлі, 2019) Бойко, Дмитро Іванович; Животовська, Лілія Валентинівна; Скрипніков, Андрій Миколайович; Сонник, Григорій Трохимович; Бойко, Дмитрий Иванович; Животовская, Лилия Валентиновна; Скрипников, Андрей Николаевич; Сонник, Григорий Трофимович; Boiko, D. I.; Zhyvotovska, L. V.; Skrypnikov, A. M.; Sonnik, G. T.
У монографії представлено дані щодо визначення клініко-психопатологічних та патопсихологічних особливостей аутоагресивної поведінки у пацієнтів з першим психотичним епізодом з урахуванням біологічних ритмів. Запропоновано використовування принципів психоосвітньої програми в рамках ранньої психосоціальної реабілітації з урахуванням індивідуального хронотипу, що дає можливість персоніфікованого підходу до лікувально-реабілітаційних заходів для даної категорії пацієнтів; В монографии представлены данные по определению клинико-психопатологических и патопсихологических особенностей аутоагрессивного поведения у пациентов с первым психотическим эпизодом с учетом биологических ритмов. Предложено использование принципов психообразовательной программы в рамках ранней психосоциальной реабилитации с учетом индивидуального хронотипа, что дает возможность персонифицированного подхода к лечебно-реабилитационных мероприятий для данной категории пациентов; The monograph presents data on the definition of clinical and psychopathological and pathopsychological features of auto-aggressive behavior in patients with the first psychotic episode with considering biological rhythms. The use of the principles of the psycho-educational program within the framework of early psychosocial rehabilitation, taking into account the individual chronotype, which allows the personified approach to medical-rehabilitation measures for this category of patients is proposed.
Афективні порушення при віддалених наслідках посттравматичного стресу
(Українська медична стоматологічна академія, 2019) Животовська, Лілія Валентинівна; Скрипніков, Андрій Миколайович; Сокіл, Антон Андрійович; Бойко, Дмитро Іванович; Животовская, Лилия Валентиновна; Скрипников, Андрей Николаевич; Сокол, Антон Андреевич; Бойко, Дмитрий Иванович; Zhyvotovska, L. V.; Skrypnikov, A. M.; Sokil, A. A.; Boiko, D. I.
Незважаючи на те, що відсоток діагностованого посттравматичного стресового розладу (ПТСР) в останні роки зростає, у літературі досить мало досліджень стосовно емоційно-особистісних порушень в періоді віддалених наслідків бойової психічної травми. У хворих з ПТСР через 2-3 роки після початку захворювання фіксувалося формування змін особистості афективно-нестійкого типу у поєднанні із ангедонією, соціальною відгородженістю, деструктивними формами поведінки, виявлялась соматогенна предиспозиція. Дослідження предикторів, механізмів виникнення, феноменології афективних порушень при віддалених наслідках посттравматичного стресу дозволить вдосконалити існуючі реабілітаційні програми, покращити показники якості життя та повернути пацієнтів до повноцінного соціального функціонування; Несмотря на то, что процент диагностированного посттравматического стрессового расстройства (ПТСР) в последние годы растет, в литературе достаточно мало исследований относительно эмоционально-личностных нарушений в периоде отдаленных последствий боевой психической травмы. У больных с ПТСР через 2-3 года после начала заболевания фиксировалось формирования изменений личности аффективно-неустойчивого типа в сочетании с ангедонией, социальной отгороженностью, деструктивными формами поведения, отмечалась соматогенная предиспозиция. Исследование предикторов, механизмов возникновения, феноменологии аффективных нарушений при отдаленных последствиях посттравматического стресса позволит усовершенствовать существующие реабилитационные программы, улучшить показатели качества жизни и вернуть пациентов к полноценному социальному функционированию; The extreme and life-threatening situations provoke the development of response to severe stress in the form of acute and post-traumatic stress disorders. Post-traumatic stress disorder (PTSD) is one of the most frequent and unfavorable forms of mental disorders in people who have experienced life-threatening situations. According to the recent research data the post-traumatic stress disorders in combatants of combat operations in the East of Ukraine have delayed and chronic form. Moreover, it has been determined that the long-term manifestations of chronic PTSD in combatants depend on its clinical variant. In 2-3 years after the onset of disease the patients with PTSD presented with the development of affective-unstable type of personality disorder in combination with social exclusion, alienation and hostility towards others. Manifestations of affective-unstable type of personality in patients were characterized by emotional instability, tendency to impulsive actions disregarding the possible consequences, outbursts of violence, affective-destructive forms of behavior in response to disapproval and criticism. As the result of the addictive PTSD type development, the systematic (almost daily) alcohol consumption to influence the “reexperience” and “flight” syndromes was registered in patients at the long-term stage. Moreover, in 100% of combatants with this type of PTSD, the primary pathological craving for alcohol was registered. In case of neurosis-like clinical variant of PTSD development, the long-term effects in the form of “energy reduction” was observed in 70.49% of patients and “loss of interests and pleasure” (anhedonia) − in 49.18% of cases. The loss of pleasure also affected the vital functions, such as sexual relations, feeling of thirst, hunger and taste of food. In 31.57% of patients the episodic paroxysmal anxiety (panic attacks) was observed. The study conducted has determined that in 75% of people who experienced psycho-emotional stress in long-term variant the somatogenic predisposition was associated with local (organ) somato-vegetative dysfunction or certain psychosomatic diseases in combination with neurosis-like psychopathological disorders and focal symptoms of organic nature. About 70% of suicidal acts in case of depressive states were associated with the problems of interpersonal relations of combatants with other people after their return from the combat area. Despite the fact that the percentage of the diagnosed post-traumatic stress disorder has been growing in recent years, there are few researches regarding emotional and personality disorders in the period of long-term effects in case of combat psychic traumas. Thus, the study of affective disorders in case of long-term effects of post-traumatic stress remains relevant issue in the modern psychiatry. The priority direction is the study of predictors, mechanisms of development and clinical features of long-term post-traumatic stress effects, which will make it possible to improve the present-day rehabilitation programs, quality of live indicators and return patients to full-fledged social functioning.

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