Toward the Goal of Leaving No One Behind: Orthostatic Dysregulation

Orthostatic dysregulation (OD), a common psychosomatic disorder in children, is caused by circulation disturbance resulting from autonomic imbalance. OD is a significant public health threat due to its association with school refusal and depression in children. During the COVID-19 pandemic, many children suffered from school closures, lack of exercise, smartphone addiction, and school refusal. The COVID-19 pandemic made it much more difficult to deliver existing approaches to patients and families with OD and increased the risk of prolonged and severe OD. In response, web-based digital health solutions are expected to support patients and families. Digital therapeutics for OD can not only deliver established treatments online, such as pharmacotherapy and behavioral therapy but also provide new interventions, such as regular mental health programs led by clinical psychologists. It is necessary to keep in mind that digital therapeutics are not intended to replace established treatments, but rather to supplement them and provide additional support. However, most research on OD has been conducted in Japan. Therefore, to provide unique findings from Japan, it is important to conduct further epidemiological research using large-scale databases in the real world and reveal the clinical characteristics and detailed epidemiology of OD, leading to the development of novel treatments.