To go or not to go: School refusal and its clinical correlates

Abstract

Problematic school refusal that is child motivated is a serious but common presentation and a child psychiatric emergency. Mental health professionals, paediatricians, educators and parents are often required to work in tandem to alleviate concerns due to this. Prolonged absence from school may lead to immediate (educational backwardness) and far‐reaching effects (psycho‐social and educational maladjustment). Psychiatric morbidity is high in school‐refusing children presenting to secondary and tertiary services and is associated with temperamental, family and environmental adversities. Outcomes can vary according to their age, duration of school refusal and environmental variables.

A Systematic Review of Somatic Symptoms in School Refusal

“…Thirteen studies reported that patients first presented to general practitioners or pediatricians in the context of unexplained somatic symptoms (31,48,53,60,61,68,(80)(81)(82)(83)(84)(85)(86), with parents sometimes not even reporting school absenteeism to their physician (53,66,87). Some doctors justified unnecessary absences (51,61).…”

“…Symptoms could increase after the weekend and following holidays (48,53) or at the beginning of a new school year (53). Multiple studies specified somatic symptoms could occur during school hours (16,66,71,77,80,94,102,105,113,114,121,122), whereas another one stated that somatic symptoms disappeared once the child was settled at school (57). Somatic symptoms disappeared if the patient could stay or return home, or during weekends and holidays (26,31,34,46,51,53,57,61,66,71,75,77,93,95,99,109,113,123,124).…”

“…Multiple studies showed that a pathophysiological organic explanation could not be found to account for the somatic symptoms in school refusers (30,48,51,(53)(54)(55)58,61,71,73,(77)(78)(79)(80)87,91,97,100,104,106,107,116,127). Terms such as "hypochondriacal" (26,82,96,128), "psychosomatic" (34,46,49,53,78,82,105,(112)(113)(114)119,127,(129)(130)(131)(132)(133)(134), "somatoform disorder" (81,86,135), "somatization" (24,136), and "hysteria" (26,…”

Psychophysiological Study of Primary School Students Depending on Gender in the Dynamics of the School Year and the Actions of Parents to Maintain and Strengthen the Health

“…Therefore, the successful adaptation of the child's body to the conditions of an educational institution is considered an important link in the subsequent formation of health and the preservation of its reserves in the future, and also helps parents to organize the correct mode of work and rest [2]. However, there are differences in the organization of prevention activities for girls and boys.…”

Variables affecting the school adaptation of secondary-school students who do not seek help: attachment, coping style, positivity, and prospects

“…Kearney, 2008;Place, Hulsmeier, Davis, & Taylor, 2002), and psychiatric diagnoses such as depressive disorder (e.g. Prabhuswamy, 2018;Prabhuswamy, Srinath, Girimaji, & Seshadri, 2007); therefore, prevention of school refusal is essential for Japan and other countries to reduce various risks that children may face.…”