Departmental Bulletin Paper 〈Originals〉Depressive symptoms in children and adolescents with orthostatic dysregulation vs. those with nephrotic syndrome

Iba, Yoshinori

40 ( 1 )  , pp.7 - 14 , 2015-06-01 , Kinki University Medical Association
<Abstract>Orthostatic dysregulation (OD), an autonomic imbalance manifesting dizziness upon standing up and vertigo as principal symptoms, is also considered to be a partly psychosomatic disorder because the condition is likely to be influenced by mental stress. Nephrotic syndrome (NS) can cause such stress in relation to recurrences, exacerbations, and vulnerability to infections. In this study we retrospectively investigated symptoms of depression in 7-to 15-year-old children with OD and NS using the Birleson Depression Self-Rating Scale for Children (DSRS-C). Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) was measured in NS patients as a urinary oxidative stress marker. In children with OD, DSRS-C scores were significantly higher than in a general population of elementary and junior high school students (P=0.00030 for elementary and junior high school students combined; P=0.0057 for junior high school students). In children with NS, DSRS-C scores were significantly lower than in the other elementary and junior high school students (P=0.019). Urinary 8-OHdG did not correlate significantly with the number of NS recurrences, duration of illness, or incidence of recurrence. No NS-related variable was found to be significantly correlated with oxidative stress. School absence often persists in OD patients even after somatic symptoms have been improved by drug therapy such as midodrine hydrochloride treatment, suggesting that symptoms of depression may prolong school absence in those with OD. Since the DSRS-C can rapidly quantify the severity of depression, early administration is recommended for children with OD.

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