IMIPRAMINE IN THE TREATMENT OF SCHOOL REFUSAL

丙咪嗪治疗拒学

• 批准号: 2247109
• 负责人: GAIL A. BERNSTEIN
• 金额: $ 11.04万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-03-01 至 1997-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2247109
• 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

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.

学校拒绝（学校恐惧症）是一个常见的童年和青少年 精神病综合症，短期和长期 后遗症。 在此需要进行控制的治疗研究 区域。 当前的建议是评估 三环类抗抑郁药和安慰剂治疗 学校拒绝使用双盲，平行设计的患者， 两者都与4周的行为学校结合使用 再入计划。 学校拒绝的儿童和青少年是异体 人口由诊断子组组成，包括 仅焦虑症，仅抑郁症以及焦虑和 抑郁症（Bernstein＆Garfinkel，1986; Bernstein，in 按）。 尽管焦虑和抑郁症的频率很高 学校拒绝者的疾病，只有两个对照研究 评估学校治疗中的三环抗抑郁药 拒绝（Gittelman-Klein和Klein，1971，1973; Berney等，1981）。 这些研究的结果是对比的。 所以， 需要进一步的研究。 将评估200名儿童和青少年。 评估 包括儿童诊断访谈的仪器和 青少年 - 修订 - 青少年版本（DICA -R -A）和诊断 儿童和青少年的访谈 - 修订后的父母版本 （DICA-R-P）以及临床医生，自我报告，父母和老师 评分量表将定义症状学的诊断和严重程度。 基于复合信息形式DICA-R-A和DICA-R-P，105 合并焦虑和抑郁症的受试者将是 随机分为两个治疗细胞：8周的咪帕明或安慰剂 结合为期4周的行为学校再入计划。 这 学校再入计划发生在 药物治疗。 一本治疗手册描述了 学校再入计划。 焦虑和抑郁评级量表和每周上学 记录是治疗反应的依赖度量。 功效 将通过重复测量分析评估治疗 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。