Pervasive refusal syndrome: systematic review of case reports - Otasowie, Paraiso, Bates Apr 2020

Sly Saint

Sly Saint

Senior Member (Voting Rights)
Abstract


Pervasive refusal syndrome (PRS) is a complex condition that affects young people leading to social withdrawal, inability or refusal to eat, drink, mobilise or speak. The affected individual regresses and is unable to self-care and quite characteristically will resist rehabilitation, worsen with praise or remain entirely passive. This systematic review was aimed at describing clinical features of PRS, current interventions and to summarise some of the nosological aspects of the condition. Without language restriction, an electronic search was conducted in Embase, PsychInfo, Medline, Cochrane library, and PubMed databases yielding 29 articles with a total of 79 cases. We performed a risk of assessment bias using an adapted Newcastle–Ottawa Scale and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

124 articles were identified, of which 29 were included and these yielded 79 cases. Seventy-six percent of the studies had a low rate of risk of assessment bias (good quality). Our results show that PRS overlaps with several conditions, mainly affects young females aged 7–15 years and has a recovery rate of 78% if diagnosed and treated early but the duration of inpatient treatment may last up to 9.44 months (8.82 SD). The patients had multiple inter-dependent risks.

The major predisposing factors included vulnerable premorbid personality and pre-existing mental disorder. Precipitating factors were stressors such as infection and traumatic experiences. Enmeshed parent–child relationship served as a maintaining factor. The themes of treatment approach are essentially rehabilitative: (1) working collaboratively with patient and family, (2) having access to multidisciplinary team, and (3) peer/group supervision.

This study has systematically evaluated a large sample of patients with PRS to ascertain its clinical features and the core elements of its treatment. Its key treatment approach is a multi-modal rehabilitative strategy that is compassionate, transparent and inclusive.
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https://link.springer.com/article/10.1007/s00787-020-01536-1

sci-hub.tw/10.1007/s00787-020-01536-1

Clinicians, support groups and even philosophers of science [8] continue to debate the specific identity of the condition given its resemblance to chronic fatigue syndrome, catatonia, depression, anxiety, functional neurologic disorder (conversion disorder), selective mutism, and eating disorder
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Afaic if a person had prior diagnosis of M.E, and given this type severity rarely happens over night, they shouldn't be given this diagnosis without really good explanations of why it wasn’t explained by a very severe M.E. diagnosis. I don’t know how commonly it’s being misused in our area, I just heard of it in relation to Esther Crawley.
 
Precipitating factors were stressors such as infection
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This is clearly not a forest, it's just a bunch of trees!

There really is no comparison in any other profession to people who are this clueless and incapable of seeing what's slapping them in the face.

I shall dub this Rube Goldberg's blunt mace of bluntness syndrome, a pervasive refusal to acknowledge that Occam's razor is indeed sharper than the bluntest roundest object in the known universe.
 
systemic revues and meta analysis has come to mean bullshit in bullshit out I do not trust any of these so called research papers for the simple reason that I do not believe that there is any due diligence . so many papers are taken on trust simply because a broken publishing industry publishes anything it can profit from.
 
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