Pervasive Refusal Syndrome

We report here on a case of severe pervasive refusal syndrome. This is of interest for three reasons. Firstly, most reported cases are adolescent girls; our case is regarding an adolescent boy. Secondly, he was successfully treated at home and thirdly, the serology showed an apparent infective pre-c...

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Bibliographic Details
Published in:Clinical child psychology and psychiatry 2012-04, Vol.17 (2), p.221-228
Main Authors: Wright, Barry, Beverley, David
Format: Article
Language:English
Subjects:
Adolescent
Adolescent girls
Autoimmune Diseases - complications
Eyes
Fatigue Syndrome, Chronic - complications
Feeding and Eating Disorders
Humans
Male
Mental Disorders - complications
Mental Disorders - therapy
Mutism
Nomenclature
Perceptual Disorders
Pervasive refusal syndrome
Rehabilitation
Streptococcal Infections - complications
Syndrome
Tic Disorders
Tics
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Summary:We report here on a case of severe pervasive refusal syndrome. This is of interest for three reasons. Firstly, most reported cases are adolescent girls; our case is regarding an adolescent boy. Secondly, he was successfully treated at home and thirdly, the serology showed an apparent infective pre-cursor to the illness with evidence of possible autoimmune serology. A 14-year old boy deteriorated from a picture where diagnosed CFS/ME developed into Pervasive Refusal Syndrome. This included the inability to move or speak, with closed eyes, multiple tics, facial grimacing, heightened sensitivity to noise (hyperacusis) and touch (hyperaesthesia), and inability or unwillingness to eat anything except small amounts of sloppy food. Successful rehabilitation is reported. Finally the issue of nomenclature is discussed, raising the question whether Pervasive Refusal Syndrome would be better renamed in a way that does not imply that the condition is always volitional and oppositional, as this can distract focus away from an alliance between family and clinicians.
ISSN:1359-1045
1461-7021
DOI:10.1177/1359104511403680