비행청소년 반복자해군과 비자해군간의 통각내성치에 대한 Naloxone 효과의 차이

Difference of Naloxone Effect on Pain Tolerance Between Delinquent Adolescents With Repetitive Self Injurious Behavior and Those Without Self Injurious Behavior

To examine the hypothesis that the endogenous opioid system is implicated in self injurious behavior (SIB), the authors measured pain tolerance before and after intravenous injection of naloxone or normal saline in a controlled test involving three groups of test subjects. 18 deliquent adolescents with more than three instances of repetive SIB and 18 without SIB were tested. Both groups were in a juvenile discriminative institution. Further 18 normal uninstitutionalized adolescents were similarly tested as a control group. The first day of the study, the authors evaluated anxiety and depression scales scores with STAl(S-A & T-A), ZAS, ZDS, BDI in all three groups. The second day, the authors measured baseline pain tolerance in all three groups and compared and analysed the difference in pain tolerance before and after intravenous injection of either naloxone or normal saline in each subgroup of the three test groups, divided randomly in half. Thus nine subjects in each subgroup received naloxone, and nine received normal saline. The results were as follows : 1) When anxiety and depression scales scores were compared between delinquent adolescent groups, regardless of SIB, in a juvenile discriminative institution with the scores of the normal control group, both anxiety and depression scales scores of the former were significantly higher statistically than those of the latter. Considering the deliquent adolescent group, comparing the repetitive SIB group and non SIB group, the result is that repetitive SIB group with significant higher statistically than non SIB group in anxiety scales scores but there was no significant difference statistically in depression scales scores between the two groups. 2) In baseline pain tolerance, there was no significant difference statisticaly between the three. 3) When comparing the pain tolerance difference before and after intravenous injection of either naloxone or normal saline in each group, there was no significant difference statistically between the non SIB and the normal control group ; b ut that of the repetitive SIB group with the intravenous injection of naloxone was significantly decreased statistically compared to that of the normal saline recipients. According to these results, the authors suggest that the endogenous opioid system is implicated in SIB and opioid blocker, naloxone, can be used clinically for the treatment of patients with SIB