Time of Day Matters: An Exploratory Assessment of Chronotype in a Forensic Psychiatric Hospital

Sleep and Rest-Activity Rhythms in Recovering Patients with Severe Concurrent Mental and Substance Use Disorder: A Pilot Study

Objective: Mental health and substance use disorders are commonly associated with disrupted sleep and circadian rest-activity rhythms. How these disorders in combination relate to sleep and circadian organization is not well studied. We provide here the first quantitative assessment of sleep and rest-activity rhythms in inpatients with complex concurrent disorders, taking into account categories of substance use (stimulant vs. stimulant and opioid use) and psychiatric diagnosis (psychotic disorder and mood disorder). We also explore how sleep and rest-activity rhythms relate to psychiatric functioning. Methods: A total of 44 participants (10 female) between the age of 20-60 years (median = 29 years) wore wrist accelerometers over 5-70 days and completed standardized questionnaires assessing chronotype and psychiatric functioning (fatigue, psychiatric symptom severity, and impulsiveness). To examine potential influences from treatment, we computed (1) length of stay; (2) days of abstinence from stimulants and opioids as a measure of withdrawal; and (3) a sedative load based on prescribed medications. Results: Participants exhibited a sustained excessive sleep duration, frequent nighttime awakenings, and advanced rest-activity phase related to sedative load. Sleep disruptions were elevated in participants with a history of opioid use. Patients with a psychotic disorder showed the longest sleep and most fragmented and irregular rest-activity patterns. Non-parametric circadian rhythm analysis revealed a high rhythm amplitude by comparison with population norms, and this was associated with greater psychiatric symptom severity. Psychiatric symptom severity was also associated with greater fatigue and later MCTQ chronotype. Conclusions: This pilot study provides initial information on the prevalence and severity of sleep and circadian rhythm disturbances in individuals with severe concurrent disorders. The results underline the need for further studies to start to understand the role of sleep in the disease and recovery process in this understudied population.

Common Ground between Biological Rhythms and Forensics

Simple Summary

Biological clocks regulate the timing of numerous body functions in adaption to daily repeating cycles in the environment, such as the sleep–wake phases that are trained by the cycling changes of night and day light. The identification of a deceased victim is a critical component in a forensic investigation, but it can be significantly hampered by the condition of the dead body and the lack of personal records and documents. This review links current knowledge on the molecular mechanisms of biological rhythms to forensically relevant aspects, including the time period since death, cause of death, the use of insects for forensics, sex and age of a person, ethnic background and development. Putting these findings in context demonstrates how the analysis of molecular clock analysis could be used as tool for future personal identification in forensic investigations.

Abstract

Biological clocks set the timing for a large number of essential processes in the living human organism. After death, scientific evidence is required in forensic investigations in order to collect as much information as possible on the death circumstances and personal identifiers of the deceased victim. We summarize the associations between the molecular mechanisms of biological rhythms and forensically relevant aspects, including post-mortem interval and cause of death, entomological findings, sex, age, ethnicity and development. Given their importance during lifetime, biological rhythms could be potential tools to draw conclusions on the death circumstances and the identity of a deceased person by mechanistic investigations of the different biological clocks in a forensic context. This review puts the known effects of biological rhythms on the functions of the human organism in context with potential applications in forensic fields of interest, such as personal identification, entomology as well as the determination of the post-mortem interval and cause of death.

A Closer Look at the Sleep/Wake Habits and Dark Triad Traits

In this study, we sought to explore the association between sleep/wake habits and the Dark Triad (DT) traits. The sample consisted of 637 university students who filled out the measures of the Dark Triad, sleep quality, daytime sleepiness, and sleep timing. There was a positive relationship between the Dark Triad composite and eveningness, and a negative relationship between the DT and circadian distinctness was observed. Psychopathy appeared as the most sleep-related DT trait, and narcissism appeared as the least sleep-related one. Psychopathy and Machiavellianism predicted bedtime prior to free days stronger than the other sleep variables. This study suggests that both sleep timing and sleep stability are influenced by higher DT traits. As sleep disturbances go along with some other comorbid mental problems, looking for the possible underlying factors such as biological markers or psychological traits is warranted.

COMPARATIVE CHARACTERISTICS OF CLINICAL INDICATORS OF THE CONDITION OF SCAR TISSUE OF THE FACIAL SKIN AT DIFFERENT STAGES OF THE POSTOPERATIVE PERIOD DEPENDING ON THE CHRONOTYPE OF THE PERSON

OBJECTIVE

The aim: The aim of the study was to improve preventive measures aimed at preventing the formation of pathological scarring of the skin in patients after elective surgery by intra- and postoperative use of cryopreserved placental cells.

PATIENTS AND METHODS

Materials and methods: The research was conducted in the Department of Maxillofacial Surgery on the basis of the Municipal Enterprise «Poltava Regional Clinical Hospital. M.V. Sklifosovsky» Poltava Regional Council. A total of 60 patients took part in the study, who were hospitalized for planned surgical interventions in the department of maxillofacial surgery.

RESULTS

Results: We obtained clinical data on the processes of scar formation in patients with morning and evening chronotype on the background of local intraoperative injection of cryopreserved placenta extract into the wound. We have proved that short people with an established evening chronotype need additional preventive measures, especially on the 90th and 180th days of the postoperative period.

CONCLUSION

Conclusions: From our study we can say with confidence that the drug "Cryocel" reduces epithelialization time, promotes optimal wound healing and leads to the formation of more aesthetic scars, which creates optimal both functional and cosmetic results.

Biological Rhythm and Chronotype: New Perspectives in Health

The circadian rhythm plays a fundamental role in regulating biological functions, including sleep–wake preference, body temperature, hormonal secretion, food intake, and cognitive and physical performance. Alterations in circadian rhythm can lead to chronic disease and impaired sleep. The circadian rhythmicity in human beings is represented by a complex phenotype. Indeed, over a 24-h period, a person’s preferred time to be more active or to sleep can be expressed in the concept of morningness–eveningness. Three chronotypes are distinguished: Morning, Neither, and Evening-types. Interindividual differences in chronotypes need to be considered to reduce the negative effects of circadian disruptions on health. In the present review, we examine the bi-directional influences of the rest–activity circadian rhythm and sleep–wake cycle in chronic pathologies and disorders. We analyze the concept and the main characteristics of the three chronotypes.