scholarly journals CLINICAL FEATURES OF ANXIETY DISORDER IN POST-COVID-19 SYNDROME AND FINDING OF ITS PREDICTORS

2021 ◽  
Vol 127 (4) ◽  
pp. 22-29
Author(s):  
Dmytro Boiko
Keyword(s):  
Circadian Rhythm ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Clinical Features ◽  
Trait Anxiety ◽  
Excessive Sweating ◽  
Increased Risk ◽  
Falling Asleep ◽  
Group 2 ◽  
Circadian Rhythm Disorders

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 clinical 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 prognostic 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 predictors of post-COVID anxiety disorder.

scholarly journals SAT-014 Insulin Treatment in Human Pregnancy Mitigates an Increased Risk of Postpartum Psychological Distress with Maternal Obesity in the Absence of a Pre-Existing Mood and Anxiety Disorder

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jessica S Jarmasz ◽  
Alexandrea Anderson ◽  
Margaret E Bock ◽  
Yan Jin ◽  
Peter A Cattini ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Maternal Obesity ◽  
Gestational Hypertension ◽  
Placental Lactogen ◽  
Mood And Anxiety Disorders ◽  
Increased Risk ◽  
Significant Difference ◽  
In Pregnancy

Abstract BACKGROUND: Pregnant women with obesity are at increased risk for peripartum depression. Maternal obesity is also associated with reduced human placental lactogen (hPL) levels, and decreased hPL transcripts were reported in women with clinical depression. In addition, hPL production may be rescued in women with obesity that were subsequently diagnosed with gestational diabetes and treated with insulin (INS). Objective: Study the effect of INS treatment in pregnancy on the risk for postpartum psychological distress (PPD) in women with and without obesity. Study Design: Using data housed at the Manitoba Centre for Health Policy (2002–2017), cohorts of women (ages 15+) with a single live birth with and without obesity were developed using weight (≥85 and <65.6 kg, respectively) and an average (1.63 m) height. Pre-existing mood and anxiety disorders within 5 years preceding delivery as well as gestational hypertension were excluded. After randomly selecting 1 birth per mother, cohorts were stratified by INS treatment during the gestational period. The risk of PPD within 1 year of delivery was assessed by Poisson regression analysis. Models were adjusted for maternal age and area-level income at delivery. Results: The risk of PPD was 27% greater among women with obesity versus without (adjusted rate ratio (aRR)=1.27, 95% CI 1.16–1.4, p<0.0001). However, women with obesity treated with INS did not have a significantly different risk of PPD compared to women without obesity whether treated with INS (aRR=0.99, 95%CI 0.48–2.02, p=0.974) or not (aRR=1.16, 95%CI 0.86–1.56, p=0.328). This suggests that the risk of PPD among women with obesity may be reduced by INS treatment; however, our ability to detect a significant difference may be limited by small cohort numbers (46 women with obesity received INS in pregnancy) or confounders for receiving INS in pregnancy. Direct comparison of INS treatment within weight groups faced the same limitations but trended toward a reduction in women with obesity who received INS (aRR=0.91, 95%CI 0.68–1.22, p=0.531). The positive association between INS treatment in pregnancy and decreased risk of PPD in women with obesity was lost when pre-existing mood and anxiety disorder was not excluded. Inclusion of pre-existing diabetes in the adjusted models did not improve model fit or contribute significantly to the differences in PPD rates. Conclusions: Maternal obesity increases the risk for PPD but this risk may be reduced by gestational INS treatment in the absence of a pre-existing mood and anxiety disorders. This correlates with the decrease and increase in hPL levels reported previously with maternal obesity without and with INS treatment (for diabetes) in pregnancy, respectively. Thus, hPL levels may serve as a possible indicator of PPD risk and a potential target for gestational INS treatment.

Circadian dysrhythm and advanced prostate cancer.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 199-199
Author(s):  
Lorelei A. Mucci ◽  
Sarah Markt ◽  
Lara Sigurdardottir ◽  
Steven W. Lockley ◽  
Katja Fall ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Circadian Rhythm ◽  
Advanced Prostate Cancer ◽  
Clock Genes ◽  
Sleep Problems ◽  
P Value ◽  
Relative Risks ◽  
Increased Risk ◽  
Falling Asleep

199 Background: The circadian rhythm regulates diverse biologic pathways including tumor oncogenes, metabolism, and cell proliferation. Dysregulation of the circadian rhythm arises from faulty input signals such as exposure to light at night, variability in core circadian rhythm genes, and variation in outputs that regulate circadian behavior including melatonin. There is compelling biologic rationale, but little human data, on circadian dysrhythm and advanced prostate cancer. Methods: We undertook an integrative molecular epidemiology study of circadian dysrhythm and advanced prostate cancer among men in the Icelandic AGES-Reykjavik cohort and the U.S. Health Professionals Follow-up Study, which allowed integration of questionnaire data, biorepositories, and long-term follow-up. We characterized circadian dysrhythm using complimentary approaches: information on sleep problems from questionnaires, prediagnostic melatonin (6-sulfatoxymelatonin) measured on first morning void urine samples, and genetic variation across twelve circadian clock genes. We used multivariable regression models to estimate relative risks (RR) and 95% confidence intervals (CI) of associations with advanced prostate cancer, adjusted for potential confounders. Results: Twenty percent of men reported sleep problems. Men who had trouble falling asleep (RR = 2.1; 95% CI 0.7-6.2) and staying asleep (RR=3.2, 95% CI 1.1-9.7) had an increased risk of developing advanced prostate cancer. Men with sleep problems had significantly lower melatonin levels compared to those without. Low melatonin levels were associated with a statistically significant 4-fold higher risk of advanced prostate cancer compared to those with high levels (95% CI: 1.25-10.0). Variant alleles in two SNPs in cryptochrome (CRY1), involved in generating and maintaining circadian rhythms, were significantly associated with risk of advanced prostate cancer in both cohorts, with a gene-level p-value<0.01. Conclusions: Our results suggest there are multiple nodes in the circadian rhythm that are associated with an increased risk of advanced prostate cancer. As such, there is the potential for complimentary strategies to target circadian disruption and reduce the risk of advanced prostate cancer.

Recognition and Treatment of Depression With or Without Comorbid Anxiety Disorders

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S1) ◽  
pp. 1-2 ◽  
Author(s):  
Mark Zimmerman ◽  
Iwona Chelminski ◽  
Sidney Zisook ◽  
David L. Ginsberg
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Clinical Significance ◽  
Psychiatric Patients ◽  
Full Range ◽  
Antidepressant Medication ◽  
Epidemiological Studies ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Increased Risk

AbstractAnxiety disorders are common in depressed patients. Several studies of the full range of Diagnostic and Statistical Manual of MentalDisorders-defined anxiety disorders in depressed psychiatric outpatients each found that when diagnoses are based on semi-structured diagnostic interviews >40% of the patients had a comorbid anxiety disorder. The recognition of comorbidity is not simply of academic interest, but it has important clinical significance. Epidemiological studies, such as the National Comorbidity Study, have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. The co-occurrence of anxiety disorders in depressed patients has been associated with a more chronic course of depression in psychiatric patients, primary care patients, and epidemiological samples. Recent research has suggested that clinicians underrecognize anxiety disorder comorbidity in depressed patients. The clinical significance of this underrecognition is highlighted by the finding that patients often want treatment to address their anxiety disorder comorbidity. When anxiety disorders are detected they often influence clinicians' selection of antidepressant medication, though some of clinicians' prescribing biases are not supported by empirical data.In this monograph, Iwona Chelminski, PhD, reviews the significance of anxiety in patients with depression as well as diagnostic instruments for recognizing this comorbidity. Next, Mark Zimmerman, MD, addresses the factors that affect the clinician's choice of antidepressant, focusing on the influence of comorbid anxiety. Finally, Sidney Zisook, MD, discusses the differential efficacy of antidepressants as well as the role of psychotherapy in patients with comorbid anxiety and depression.

Abstract 167: Predictors of Anxiety Disorder Episodes and Device Related Distress in the First Five Years following Implantable Cardioverter Defibrillator Placement

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Gina Magyar-Russell ◽  
Christopher H Morrell ◽  
Gordon F Tomaselli
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Trait Anxiety ◽  
Medical Condition ◽  
Functional Limitations ◽  
Self Report ◽  
Empirical Literature ◽  
Emotional States ◽  
Compulsive Disorder ◽  
Axis I

Trait anxiety is a dispositional factor that predisposes individuals to respond to perceived threats with more frequent and intense elevations in emotional states associated with arousal of the autonomic nervous system, which is thought to lead to the development of anxiety disorders. Trait anxiety has demonstrated promise in the empirical literature as a potential predictor of long term outcomes in ICD recipients. The present study adds novel information to this body of literature by studying the relation of trait anxiety to clinical diagnoses of anxiety disorders based on the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID). Two hundred and seven recipients of ICDs within the past five years were evaluated using the SCID to establish past and current anxiety disorder diagnoses. Self-report questionnaires were administered to assess device-related appraisals and functional impairment. Participants were 70% (n=144/207) male, 63% (n=130/207) married and 29% currently working (60/207) with a mean age of 63.0 (±12.3) years. Ninety-seven (47%) shocked and 110 (53%) non-shocked ICD recipients were interviewed. ICD recipients high in trait anxiety (n = 59/207, 29%) had significantly higher rates of current episodes of obsessive compulsive disorder (χ 2 = 9.05; p<.01), and anxiety disorder due to a general medical condition (GMC; χ 2 = 6.38; p<.05) during the first five years post ICD implant in comparison to those low in trait anxiety (n=147/207, 71%). Additionally, ICD recipients high in trait anxiety had significantly higher rates of a history of episodes of anxiety disorder due to GMC (χ 2 = 9.05; p<.001). ICD recipients high in trait anxiety (n = 59, 29%) reported greater device-related distress ( t = 5.65;p<.001), greater body image concerns ( t =2.39;p<.01), and greater fear of shock ( t = -3.98;p<.001), as well as fewer positive perceptions of their ICD ( t = 2.39; p<.05). Moreover, ICD recipients high in trait anxiety reported greater functional limitations ( t = 5.69; p<.001), and greater perceptions of disability in work, social, and family life ( t = -4.09; p<.001). Women (n=63/207; 30%) reported greater mean levels of trait anxiety ( t = -2.10; p<.05) and fear of shock ( t = -2.41; p<.05) in comparison to men. Individuals who met criteria for current panic disorder ( t = 2.86; p<.01), agoraphobia ( t = 4.78; p<.001), social phobia ( t = 3.04; p<.05), posttraumatic stress disorder ( t = 3.82; p<.01), and anxiety due to GMC ( t = 3.94; p<.001) were significantly younger than those without these diagnoses. The results from the current study suggest that assessment of trait anxiety may help clinicians identify individuals at risk for poor adjustment following ICD placement, even before implantation. Early identification of risk for maladjustment via pre-implant predictors might allow ICD recipients to enjoy the full benefits associated with these devices - longer and better quality of life.

Recognition and Treatment of Depression with or Without Comorbid Anxiety Disorders

CNS Spectrums ◽  
2006 ◽  
Vol 11 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Mark Zimmerman ◽  
Iwona Chelminski ◽  
Sidney Zisook ◽  
David L. Ginsberg
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Clinical Significance ◽  
Psychiatric Patients ◽  
Full Range ◽  
Antidepressant Medication ◽  
Epidemiological Studies ◽  
Comorbid Anxiety ◽  
Depressed Patients ◽  
Increased Risk

ABSTRACTAnxiety disorders are common in depressed patients. Several studies of the full range of Diagnostic and Statistical Manual of Mental Disorders-defined anxiety disorders in depressed psychiatric outpatients each found that when diagnoses are based on semi-structured diagnostic interviews >40% of the patients had a comorbid anxiety disorder. The recognition of comorbidity is not simply of academic interest, but it has important clinical significance. Epidemiological studies, such as the National Comorbidity Study, have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. The co-occurrence of anxiety disorders in depressed patients has been associated with a more chronic course of depression in psychiatric patients, primary care patients, and epidemiological samples. Recent research has suggested that clinicians underrecognize anxiety disorder comorbidity in depressed patients. The clinical significance of this underrecognition is highlighted by the finding that patients often want treatment to address their anxiety disorder comorbidity. When anxiety disorders are detected they often influence clinicians' selection of antidepressant medication, though some of clinicians' prescribing biases are not supported by empirical data.In this monograph, Iwona Chelminski, PhD, reviews the significance of anxiety in patients with depression as well as diagnostic instruments for recognizing this comorbidity. Next, Mark Zimmerman, MD, addresses the factors that affect the clinician's choice of antidepressant, focusing on the influence of comorbid anxiety. Finally, Sidney Zisook, MD, discusses the differential efficacy of antidepressants as well as the role of psychotherapy in patients with comorbid anxiety and depression.

scholarly journals Effects of Heavy Metal Toxicity on Anxiety Disorder

2021 ◽  
Vol 2 (8) ◽  
pp. 660-668
Author(s):  
Mfem CC ◽  
Seriki SA ◽  
Oyama SE
Keyword(s):  
Heavy Metals ◽  
Heavy Metal ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Human Body ◽  
The Body ◽  
Panic Attacks ◽  
Control Group ◽  
Group 2 ◽  
High Doses

Background: Several heavy metals are found naturally in the earth crust and are exploited for various industrial and economic purposes. Among these heavy metals, a few have impact on the human body. Though some of these metals only have effect on human physiology in high doses, others such as cadmium, mercury, lead, chromium, silver, and arsenic have delirious effects in the body even in minute quantities, causing acute and chronic toxicities in human. Anxiety is a common psychiatric disorder among men and women. Occasional anxiety may be a normal a part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). This study examined a major environmental risk factor of anxiety disorder and how the adverse impact of anxiety disorder could be ameliorated using zinc and vitamin E. Methods: Animals used for the researched were grouped into four. Group 1 represents control group; Group 2 represents animals exposed a heavy metal (CaCl2); Group 3 represents animals exposed to CaCl2 and then treated with zinc; and Group 4 represents animals exposed to CaCl2 and then treated vit E. Results: Results showed that exposure to heavy metals (CaCl2 in particular) causes severe anxiety disorders. Results also showed zinc and vit E have the capacity to ameliorate anxiety disorder caused by heavy metals. Conclusion: The human body should be adequately protected as man interacts with heavy metals to prevent anxiety disorder, and where a patient becomes a victim of the disorder, zinc and vit E could be used to manage the case.

Improving the Recognition of Anxiety Disorders in Depressed Patients

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S1) ◽  
pp. 2-4
Author(s):  
Iwona Chelminski
Keyword(s):  
Primary Care ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Panic Attacks ◽  
Depressed Patients ◽  
Increased Risk ◽  
History Of ◽  
Primary Care Patients

There is considerable symptom overlap and high levels of comorbidity between anxiety disorders and depression. The recognition of this comorbidity has both academic interest and clinical significance. Epidemiological studies have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. These individuals also tend to have a more chronic course of depression, as observed in psychiatric patients, primary care patients, and epidemiological samples. Van Valkenberg and colleagues reported that depressed patients with anxiety had poorer outcome and greater psychosocial impairment than those without an anxiety disorder. In the National Institute of Mental Health Collaborative Depression Study, the presence of panic attacks predicted a lower rate of recovery during the first 2 years of the follow-up interval. Similarly, Grunhaus found poorer outcome in depressed patients with comorbid panic disorder than in depressed patients without panic. In an 8-month follow-up study, depressed primary care patients with a history of generalized anxiety disorder (GAD) or panic disorder were less likely to have recovered from their depressive episode.Gaynes and colleagues prospectively followed primary care patients with major depressive disorder (MDD) every 3 months for 1 year after their initial diagnostic evaluation. At baseline, half of the original 85 patients had a coexisting anxiety disorder, the most frequent being social phobia (n=38). Twelve months after intake, 68 of the patients were available for the final interview. Those with a comorbid anxiety disorder were significantly more likely to still be in an episode of depression (82% vs 57%; risk ratio=1.44; 95% CI 1.02-2.04), and they experienced more disability days during the course of the 12 months than the depressed patients without an anxiety disorder (67.1 days vs 27.5 days).

scholarly journals The Effectiveness of Antidepressant Combined with Quranic CBT in Reducing Anxiety Level of Moslem Outpatient withh Anxiety Disorder in Sultan Agung Islamic Hospital in Semarang

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Metrikana Novembrina ◽  
Dinia Eko Kusmianti Putri ◽  
Ferika Indrasari ◽  
Wahyu Setyaningsih
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Antidepressant Drugs ◽  
Sampling Technique ◽  
Anxiety Level ◽  
Not Given ◽  
Treatment Trial ◽  
Group 2 ◽  
Emotional Condition ◽  
Group 1

Anxiety disorders is an emotional condition in which a person feels excessively anxious and it is generally caused by the excessive perception of a particular danger threatens the security of an individual and sometimes interferes with the daily activities and social interaction of an individual. This study aimed to determine the effectiveness of the Quranic CBT in reducing the anxiety level of the outpatient with anxiety disorder in Sultan Agung Islamic Hospital, Semarang. This was a treatment trial research using purposive sampling technique. In this study as much as 20 patients diagnosed with anxiety disorders and in the treatment with antidepressants were randomly divided into 2 groups. Group 1 was the patients undergoing therapy with antidepresant and also given Quranic CBT. Group 2 was the patients using antidepressant drugs and not given Quranic CBT therapy. This showed that the Quranic CBT method was effective in reducing the anxiety level.

scholarly journals Investigation of early and lifetime clinical features and comorbidities for the risk of developing treatment-resistance depression in a 13-year nationwide cohort study

2020 ◽  
Author(s):  
Shiau-Shian Huang ◽  
Hsi-Han Chen ◽  
Jui Wang ◽  
Wei J. Chen ◽  
Hsi-Chung Chen ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Clinical Features ◽  
Cox Regression ◽  
Treatment Resistant Depression ◽  
Treatment Resistant ◽  
Psychiatric Comorbidities ◽  
Prescription Patterns ◽  
Increased Risk ◽  
Resistant Depression ◽  
Depressive Patients

Abstract Background To investigate the risk of developing treatment-resistant depression among depressive patients by examining clinical features, early prescription patterns, and early and lifetime comorbidities. Methods A total of 31,422 depressive inpatients were followed from diagnostic onset to more than ten-years. treatment-resistant depression was defined by altered antidepressant treatment regimens more than twice or being admitted after received at least two antidepressant treatments. Multiple regression and Cox regression models were used to examine the effects of physical and psychiatric comorbidities, psychosis, and early prescription patterns on the risk of developing treatment-resistant depression. Results Female depressive patients (21.24%) were more likely to become treatment-resistant depression than males (14.02%). Early anxiety disorder was commonly observed in the treatment-resistant depression comparing with non-treatment-resistant depression groups (81.48 vs. 58.96%, p < 0.0001). Lifetime anxiety disorder exhibited the highest population attributable fraction (43.1%). 70% of patients with multiple psychiatric comorbidities developed treatment-resistant depression during follow-up. Results in Cox regression further identified that functional gastrointestinal disorders significantly increased the risk of treatment-resistant depression (aHR = 1.18). A higher dose of antidepressants in early disease course exhibited increased risk for treatment-resistant depression (p < 0.0001). Conclusion Our findings indicate the need to monitor early comorbidities and polypharmacy patterns in patients with major depressive disorder that are associated with an elevated risk for treatment-resistant depression.

scholarly journals EFFECT OF MELATONIN ON PAIN SYNDROME IN DELAYED SLEEP PHASE DISORDER IN PATIENTS WITH PARKINSON'S DISEASE

2021 ◽  
Vol 21 (3) ◽  
pp. 111-116
Author(s):  
A.D. Shkodina
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Circadian Rhythm ◽  
Pain Syndrome ◽  
Sleep Phase ◽  
Delayed Sleep Phase Disorder ◽  
Delayed Sleep Phase ◽  
Group 2 ◽  
Delayed Sleep ◽  
Circadian Rhythm Disorders

Parkinson’s disease is characterized mainly by damage to the neurons of the substantia nigra and other brain structures and manifested by motor and non-motor symptoms. In patients with Parkinson’s disease receiving dopaminergic therapy, a later onset of sleep has been identified that is associated with the development of the delayed sleep phase disorder. The delayed sleep phase disorder is characterized by a persistent delay in the circadian rhythm that causes a delay in the desired time of falling asleep and waking up. According to clinical guidelines for the treatment of delayed sleep phase disorder, exogenous melatonin is recommended. Along with this, its analgesic properties have been reported. At the same time circadian regulation of fluctuations of painful sensations transmission by either peripheral or central alarm system has been reported. In particular, the two-way connection between the nociceptive system and the circadian rhythm in the human body determines the possibility of mutual influence between these systems. However, the question of the therapeutic effect of melatonin in the presence of concomitant pathology on the circadian rhythm disorders, and, in particular, delayed sleep phase disorder that is a topical issue for patients with Parkinson's disease, is still remaining unexplored. The aim of the study is to compare the changes in subjective perception of pain in patients with Parkinson's disease, who received melatonin therapy and who did not, in delayed sleep phase disorder. We conducted a prospective study that included 48 patients with Parkinson's disease. Circadian rhythm disorders were diagnosed according to the criteria of the International Classification of Sleep Disorders-3. The diagnosis of delayed sleep phase disorder was made on the basis of a clinical interview, filling in a sleep diary and daily thermometry for 7 days. The examined patients were divided into 2 groups according to the chosen method of treatment: group 1 - patients with Parkinson's disease and delayed sleep phase disorder receiving melatonin; group 2 - patients with Parkinson's disease and delayed sleep phase disorder receiving only general recommendations for improving sleep quality and daily functioning without medical intervention. The Unified Parkinson's Disease Rating Scale was used to assess the severity of patients’ clinical condition. The intensity of the pain syndrome was assessed on a visual-analogue scale. The McGill Questionnaire was used to analyze subjective experiences of pain. The patients of group 1 were prescribed to take melatonin, 1 tablet in a dose of 3 mg at 22:00. Individuals in group 2 received general recommendations on the schedule of sleep-wake cycles, light regime and sleep hygiene. Patients with Parkinson's disease and delayed sleep phase disorder have been diagnosed with mild to moderate pain. Treatment of delayed sleep phase disorder in patients with Parkinson's disease reduces the intensity and modality of the pain syndrome, which may be due to improved functioning of the descending pain modulation system and restoration of rhythmic expression of internal clock genes. The administration of melatonin as part of a comprehensive approach to the treatment of circadian rhythm disorders helps to reduce sensory sensations and affective experiences caused by pain that indicates the potential antinociceptive effect of melatonin in the treatment of circadian disorders.

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