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

1.本研究领域的主要目的是对拒绝上学儿童的治疗和预后，因此，作为初步临床研究，我们研究了在我们诊所使用抗抑郁药物治疗这些儿童的效果。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。在接受阿米替林、氯丙咪嗪、左美丙嗪、舒必利治疗的一组中，拒绝上学的情况改善了53%，而在未接受药物治疗的一组中，改善了60%。然而，由于这项研究不是一个前瞻性的对照研究，只有那些病情更严重的儿童才接受抗抑郁药治疗的可能性是不能否认的。作为一种尝试，以实验证实三环类抗抑郁药治疗的有效性，作为一种时间疗法的儿童拒绝上学，我们目前正在进行一系列的实验大鼠。于一体的 ...更多信息 目前正在进行的实验中，通过实验改变了光-暗循环，并测量了大鼠获得再夹带的速度。到目前为止，对照组与地昔帕明、丙咪嗪和氯丙咪嗪组之间无显著差异。在以前的研究中，我们已经证明，昼夜节律的各种临床参数被打乱的儿童拒绝上学。因此，在本研究中，这种干扰和预后之间的关系进行了研究。在尿钠排泄的昼夜节律、夜间深部体温和脉率方面，最初存在异常的组与不存在异常的组之间的预后没有差异。就β-内啡肽水平的昼夜节律而言，昼夜节律的存在与否与近期预后显著相关。然而，当研究长期预后时，这种相关性不存在。所研究的案例数量相当少，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