Photosensitivity and gene abnormality in circadian rhythm sleep disorders

本研究的目的是探讨给予光疗法和社会线索的住院治疗的效果，并用图画-挫折研究(P-F研究)阐明其心理特征。研究对象为2004-04/2005-12我科病房收治的30例青春期拒绝就学患者，其中睡眠延迟综合征18例，DPS患者5例，非24小时睡眠-觉醒综合征5例，不规则睡眠-唤醒节律7例，其中男20例，女10例，平均年龄16.0±1.4岁，范围13~18岁。改善(I)组和未改善(UI)组的睡眠觉醒节律在住院年龄和发病年龄之间有显著差异。I组的住院年龄和发病年龄均高于UI组。拒绝就学患者，尤其是睡眠-觉醒节律和出院后不能改善就学情况的患者，其心理特征为低攻击性、低表达不满、高情感压抑、低社会兴趣和高自责。入院后睡眠-觉醒节律未改善的患者存在上述心理问题。因此，他们可能需要采取自我主张训练等心理干预措施。住院和光疗对治疗昼夜节律睡眠障碍很有用。我们实验室一直在进行患者的基因多态性研究。

Objectives of the study were to investigate the efficacy of hospitalization treatment with giving light therapy and social cues and to clarify their psychological characteristics using Picture-Frustration Study (P-F Study). The participants were 30 patients with circadian rhythm sleep disorders (18 delayed sleep phase syndrome ; DSPS patients, 5 non-24 hour sleep wake syndrome, 7 irregular sleep-wake rhythm) with school refusal during adolescence consisting of 20 boys and 10 girls (mean age±SD=16.0±1.4,range = 13-18) staying our ward during the period of between April 2004 and December 2005.Over 90% of patients with school refusal improved their sleep-wake rhythm just after hospitalization, over 50% of them continued to improve their sleep-wake rhythm after discharge and were able to attend school after that. Significances between groups of improvement (I) and un-improvement (UI) in sleep wake rhythms were observed in the age of hospitalization, and the age of onset. I group showed higher ages of hospitalization and onset than UI group. The psychological characteristics for DSPS patients with school refusal, especially in patients who were not able to improve sleep-wake rhythm and school refusal after discharge were low aggression, low expression of their dissatisfaction, high suppression of their emotion, low social interest and high self-reproof. Patients who did not show improvement their sleep-wake rhythm through hospitalization have some psychological problems such as those mentioned above. Therefore, they may need to take psychological intervention such as the self-assertion training. Hospitalization and light therapy is useful for the treatment of circadian rhythm sleep disorders. The gene morphism study for patients have been undertaking in our laboratory.