The relationship between steady-state plasma concentraton and clinical effect of imipramine in the treatment of nocturnal enuresis was studied in 22 hospitalised children. After 1 week on placebo the children were given imipramine in a fixed dose of about 1 mg/kg for 3 weeks. The enuresis frequency decreased significantly from the placebo to the first week on imipramine, but then no further improvement was observed. There was a significant correlation between steady-state plasma concentration of desipramine or imipramine + desipramine and the reduction in enuresis frequency during imipramine treatment. The optimum effect was obtained when steady-state levels of imipramine + desipramine were above 60 microgram/L; i.e. the effective concentration in enuresis is 3 to 4 times lower than in antidepressive therapy. Dose- and weight-corrected, steady-state plasma concentration of imipramine and desipramine were not significantly different from those previously observed in younger adults. In 1 child, a transient rise in imipramine and desipramine concentration was seen during a period with fever and bacterial infection.
Twenty-three child psychiatric patients with severe disturbances in language development and social relatedness were investigated for occurrence of fragile X-chromosomes (fra(X] and other chromosome abnormalities. One boy with fra(X) was found. He presented a characteristic infantile autistic syndrome.
The prevalence of herpes simplex virus (HSV) antibodies has been investigated in 123 child psychiatric patients and 86 normal children. HSV antibodies were measured by ELISA technique. The prevalence of HSV antibodies in different diagnostic groups (conduct disorder, emotional disorder, hyperkinetic syndrome, anorexia nervosa, infantile autism and borderline schizophrenia in childhood) was compared with age-matched normal children, but no significant differences were found.
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