Pervasive refusal syndrome
Encyclopedia
Pervasive refusal syndrome (PRS) is a rare but serious child psychiatric disorder that was first described by Bryan Lask and colleagues in 1991. As of 2011, it is not included in the standard psychiatric classification systems
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PRS is characterized by a determined unwillingness of a person to engage in activities, including eating, drinking, walking, talking and self-care. The person will withdraw socially and exhibits anger and active resistance against attempts to provide care. 75% of the PRS cases occur in girls aged 8 to 15, with a mean age of 10.5, and the disorder can be life-threatening.
Cases of PRS are often associated with intelligent children that have a conscientious, perfectionist personality. A family with a psychiatric history or environmental stress factors can also play a role. Treatment of this disorder requires gentle encouragement and patient, loving care. Hospitalization is almost always necessary and the recovery period is lengthy; typically 12.8 months. During the recovery period symptoms disappear in the opposite order they appear. That is to say that if food refusal was the first symptom to appear then it would be the last to disappear and if another symptom appears later on, it will disappear relatively early in the recovery process. About 67% of the cases show complete recovery.
PRS may be linked to learned helplessness
, and so it can be important for the patient to be able to manage the rate of their recovery. Music therapy
may help in this regard as it provides empowerment by giving the patient choice and control, while allowing for improvisation
can result in a sense of affirmation and validation; all important for a successful recovery.
Classification of mental disorders
The classification of mental disorders, also known as psychiatric nosology or taxonomy, is a key aspect of psychiatry and other mental health professions and an important issue for consumers and providers of mental health services...
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PRS is characterized by a determined unwillingness of a person to engage in activities, including eating, drinking, walking, talking and self-care. The person will withdraw socially and exhibits anger and active resistance against attempts to provide care. 75% of the PRS cases occur in girls aged 8 to 15, with a mean age of 10.5, and the disorder can be life-threatening.
Cases of PRS are often associated with intelligent children that have a conscientious, perfectionist personality. A family with a psychiatric history or environmental stress factors can also play a role. Treatment of this disorder requires gentle encouragement and patient, loving care. Hospitalization is almost always necessary and the recovery period is lengthy; typically 12.8 months. During the recovery period symptoms disappear in the opposite order they appear. That is to say that if food refusal was the first symptom to appear then it would be the last to disappear and if another symptom appears later on, it will disappear relatively early in the recovery process. About 67% of the cases show complete recovery.
PRS may be linked to learned helplessness
Learned helplessness
Learned helplessness, as a technical term in animal psychology and related human psychology, means a condition of a human person or an animal in which it has learned to behave helplessly, even when the opportunity is restored for it to help itself by avoiding an unpleasant or harmful circumstance...
, and so it can be important for the patient to be able to manage the rate of their recovery. Music therapy
Music therapy
Music therapy is an allied health profession and one of the expressive therapies, consisting of an interpersonal process in which a trained music therapist uses music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help clients to improve or maintain their...
may help in this regard as it provides empowerment by giving the patient choice and control, while allowing for improvisation
Musical improvisation
Musical improvisation is the creative activity of immediate musical composition, which combines performance with communication of emotions and instrumental technique as well as spontaneous response to other musicians...
can result in a sense of affirmation and validation; all important for a successful recovery.