A SCHOOL REFUSAL CASE WITH BIOLOGICAL RHYTHM DISTURBANCE AND MELATONIN THERAPY

An 18-year-old male high school student with school refusal and circad ian rhythm disturbance is reported. At 17 years of age, he was unable to attend school because of a reversal of the daily rhythm and a moder ate depressive feeling. Other circadian rhythms, including deep body t emperature (DBT), and plasma melatonin, cortisol and beta-endorphin, a lso showed quite different or abnormal curves compared with those in n ormal controls. He was treated with methyl B-12 and melatonin, which n ormalized the circadian rhythm, i.e. it became entrained to a 24-h per iod, and the DBT and hormonal rhythms became closer to normal patterns . These results suggest that desynchronization of the biorhythms, part icularly the circadian rhythm, may be one of the important causes of s chool refusal in Japan, and melatonin and methyl B-12 might be useful for treatment of the condition.