Studies of biological rhythms in children with school-refusal -special emphasis on treatment and prognosis

1. 本研究的主要目的是研究拒学儿童的治疗和预后，因此，作为初步的临床研究，我们的临床研究了抗抑郁药物治疗对这些儿童的影响。该研究的对象包括47名拒绝上学的儿童，他们的治疗细节和预后都有很好的记录。阿米替林组，氯丙帕明组。左旋丙嗪，磺胺吡啶，拒绝上学的情况改善了53%而没有接受药物治疗的一组，改善了60%然而，由于该研究不是前瞻性对照研究，因此不能否认只有那些病情较严重的儿童才接受抗抑郁药治疗的可能性。为了从实验上证实三环类抗抑郁药物治疗拒学儿童的有效性，我们目前正在进行一系列的大鼠实验。在目前正在进行的更多的实验中，通过实验改变了光暗循环，并测量了大鼠获得再娱乐的速度。到目前为止，对照大鼠与地西帕明、丙咪嗪和氯丙帕明治疗的大鼠之间没有观察到显著差异。在之前的研究中，我们已经证明了拒学儿童的各种临床参数的昼夜节律受到干扰。因此，在本研究中，研究了这种干扰与预后的关系。在尿钠排泄的昼夜节律、夜间深体温和脉搏率方面，最初出现异常的组和未出现异常的组在预后方面没有差异。在β -内啡肽水平的昼夜节律方面，有无昼夜节律与即时预后有显著相关性。然而，当研究长期预后时，这种相关性不存在。所研究的病例数量相当少，需要进一步详细评价。少

1. The principal purpose of the present field of study is the treatment and prognosis of children with school refusal thus, as the initial clinical study, the effect of treatment with anti-depressant medication in these children at our clinic was studied. The subject of the study consisted of 47 children with school refusal in whom the detail of the treatment as well as the prognosis was well documented. In the group receiving amitriptyline, clomipramine.levomepromazine, sulpyride, the school refusal improved 53% whereas in the group not treated with medication, 60% improved. However, since the study was not a prospective controlled one, the possibility of only those children with more severe condition illness were treated with antidepressant cannot be denied.2. As an attempt to experimentally substantiate the effectiveness of tricyclic antidepressant treatment as a chronotherapy in children with school refusal, we are currently conducting a series of experiments on rats. In one of the … More experiments currently in progress, light-dark cycle is experimentally altered and the rapidity in which the rats obtain reentrainment has been measured. Up to the present time, no significant difference has been observed between the controlled rats and those treated with desipramine, imipramine, and clomipramine.3. In the previous study, we have demonstrated that circadian rhythm of various clinical parameters are disturbed in children with school refusal. In the present study therefore, the relationship between such disturbance and the prognosis was studied. In terms of circadian rhythm of urine sodium excretion, nocturnal deep body temperature and pulse rate, there was no difference in prognosis between the group in which the abnormality was initially present and in those where it was absent. In term of circadian rhythm of beta-Endorphin level, there was a significant correlation between the presence or absence of the circadian and the immediate prognosis. However, when long term prognosis was studied such correlation was absent. The number of the cases studied was rather small and further detailed evaluation is needed. Less