Outcome of children with school refusal.
OBJECTIVE
To assess prospectively the psychiatric diagnostic status, psychosocial correlates, and short-term outcome of youngsters with school refusal.


METHODS
Thirty-three subjects (8-16 years) presenting with school refusal to a tertiary Child and Adolescent Psychiatry service were evaluated. Instruments administered at baseline and after 3 months (including an outcome measure at 3 months) were: The Missouri Assessment of Genetics Interview for Children (MAGIC) to ascertain psychiatric diagnoses, a modified version of Parent Interview Schedule (PIS), and the Children's Global Assessment Scale (CGAS).


RESULTS
Twenty-nine subjects (87.9%) had a psychiatric diagnosis at baseline. Depressive disorder (63.6%) was commonest followed by specific phobias (30.3%). Psycho-social factors influenced school refusal in a majority (87.9%). Twenty of the thirty subjects (66.6%) who could be followed-up had returned to school. Psychiatric diagnosis persisted in 16 subjects. Younger age, being last-born, no or one diagnosis, and good baseline functioning predicted a favorable outcome.


CONCLUSIONS
Psychiatric morbidity is high in a clinic population of youngsters with school refusal. It is associated with temperamental, family, and other environmental adversities. Short-term outcome in these children is largely favourable in terms of return to school and global functioning.
Prabhuswamy
Mukesh
M
Child and Adolescent Psychiatry Services, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India. ypmukesh@gmail.com
Srinath
Shoba
S
Girimaji
Satish
S
Seshadri
Shekhar
S
D000041:Absenteeism; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D012574:Schools