为什么儿童精神疾病变得越来越普遍?

Reiner Buchhorn
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摘要

未标明:在过去几十年中,观察到需要医疗保健的新的儿科问题增加,如饮食失调、行为和注意力问题。基于精神疾病伴有自主神经功能障碍的假设,我们比较了注意缺陷/多动障碍(ADHD)儿童的动态心电图心率变异性(HRV)与健康儿童和1997年以来的历史对照。方法:分析ADHD患儿(平均年龄10.8岁)用药前或用药期间24小时动态心电图HRV参数SDNN、rMSSD和pNN50。将这些数值与年龄匹配的健康儿童进行比较。结果:与健康对照相比,接受和未接受MPH治疗的ADHD儿童的平均心率显著提高,pNN50显著降低,RMSSD显著降低。健康儿童的pNN50和RMSSD值低于1997年的历史对照组。结论:与健康儿童相比,ADHD儿童青少年早期副交感神经活动峰值(HRV值pNN50和RMSSD)降低。与历史对照相比,这些数值在健康儿童中也有所降低。迷走神经活动的减少——根据波吉斯的多迷走神经理论——会对儿童的社会和情感发展产生影响。此外,这一观察结果可能会增加心血管风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Why are psychiatric disorders in children becoming more and more common?

Unlabelled: In the last decades, an increase of new paediatric problems requiring medical care like eating disorders, behavioural and attention problems has been observed. Based on the hypothesis that mental illness is accompanied by autonomic dysfunction, we compared measurements of heart rate variability (HRV) in Holter ECG's from children with attention deficit/hyperactivity disorder (ADHD) with those of healthy children and a historical control from 1997.

Method: We analysed the HRV parameters SDNN, rMSSD and pNN50 from 24 hours Holter ECG from children (mean age 10.8 years) with ADHD before or during medical therapy with methylphenidate (MPH). These values were compared with aged matched healthy children.

Results: Compared to healthy controls ADHD children with and without MPH treatment showed significantly higher mean heart rates, lower pNN50 and lower RMSSD. pNN50 and RMSSD values of healthy children are lower compared to the historical control group from 1997.

Conclusion: Compared to healthy children the peak of parasympathic activity measured by the HRV values pNN50 and RMSSD in early adolescence was reduced in children with ADHD. Compared to a historical control these values are also reduced in healthy children. A reduced vagal activity will--within the meaning of W. Porges polyvagal theory--have consequences on the social and emotional development of children. Moreover this observation may have consequences for an enhanced cardiovascular risk.

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