IMIPRAMINE IN THE TREATMENT OF SCHOOL REFUSAL

丙咪嗪治疗拒学

基本信息

批准号：
2247111
负责人：
GAIL A. BERNSTEIN
金额：
$ 5.45万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
1992
资助国家：
美国
起止时间：
1992-03-01 至 1999-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2247111
关键词：
adolescence (12-20) anxiety child (0-11) depression human subject human therapy evaluation imipramine mental disorder chemotherapy mental disorders mental health services middle childhood (6-11) phobias schools tricyclic antidepressant

项目摘要

School refusal (school phobia) is a common childhood and adolescent psychiatric syndrome with significant short-term and long-term sequelae. There is a need for controlled treatment studies in this area. The current proposal is to evaluate the efficacy of the tricyclic antidepressant imipramine and placebo in the treatment of school refusal patients employing a double-blind, parallel design, both administered in combination with a 4-week behavioral school reentry program. Children and adolescents with school refusal are a heterogenous population comprised of diagnostic subgroups including those with anxiety disorder only, depressive disorder only and both anxiety and depressive disorders (Bernstein & Garfinkel, 1986; Bernstein, in press). Although there is a high frequency of anxiety and depressive disorders in school refusers, only two controlled studies have evaluated tricyclic antidepressants in the treatment of school refusal (Gittelman-Klein and Klein, 1971,1973; Berney et al, 1981). The results of these investigation are contrasting. Therefore, further research is needed. 200 children and adolescents will be evaluated. Assessment instruments including the Diagnostic Interview for Children and Adolescents - Revised - Adolescents Version (DICA-R-A) and Diagnostic Interview for children and Adolescents - Revised - Parent Version (DICA-R-P), as well as clinician, self-report, parent and teacher rating scales, will define diagnoses and severity of symptomatology. Based on composite information form DICA-R-A and DICA-R-P, 105 subjects with comorbid anxiety and depressive disorders will be randomized to two treatment cells: 8 weeks imipramine or placebo in combination with a 4-week behavioral school reentry program. The school reentry program occurs during the first four weeks of medication treatment. A treatment manual describes details of the school reentry program. Anxiety and depression rating scales and weekly school attendance records are dependent measures of treatment response. Efficacy of treatment will be evaluated with repeated measures analyses of variance. All subjects will be reevaluated at one year after completing the treatment study to gather follow-up data.

拒绝上学（学校恐惧症）是儿童和青少年的常见现象具有显着的短期和长期的精神综合征后遗症。这方面需要进行对照治疗研究区域。目前的建议是评估该方案的有效性三环类抗抑郁药丙咪嗪和安慰剂治疗采用双盲、平行设计的拒绝上学患者，两者均与为期 4 周的行为学校结合进行再入计划。拒绝上学的儿童和青少年是一个异类由诊断亚组组成的人群，包括患有以下疾病的人群仅焦虑障碍、仅抑郁障碍以及焦虑和抑郁障碍抑郁症（Bernstein & Garfinkel，1986；Bernstein，in 按）。尽管焦虑和抑郁的频率很高拒绝上学者的障碍，只有两项对照研究发现评估三环类抗抑郁药在学校治疗中的作用拒绝（Gittelman-Klein 和 Klein，1971，1973；Berney 等，1981）。这些调查的结果是截然不同的。所以，需要进一步研究。 200 名儿童和青少年将接受评估。评估工具，包括儿童诊断访谈和青少年 - 修订版 - 青少年版本 (DICA-R-A) 和诊断儿童和青少年访谈 - 修订版 - 家长版 (DICA-R-P)，以及临床医生、自我报告、家长和老师评定量表将定义诊断和症状的严重程度。基于 DICA-R-A 和 DICA-R-P 的综合信息，105 患有焦虑症和抑郁症共病的受试者将随机分配到两个治疗单元：8周丙咪嗪或安慰剂与为期 4 周的行为学校重返课程相结合。这学校重新入学计划在开学后的前四个星期内进行药物治疗。治疗手册描述了治疗的细节学校重返校园计划。焦虑和抑郁评级量表以及每周上学率记录是治疗反应的相关衡量标准。功效将通过重复测量分析来评估治疗方差。所有科目将在一年后重新评估完成治疗研究以收集后续数据。