title: Asylum-seeking children with severe loss of activities of daily living: clinical signs and course during rehabilitation.
abstract: OBJECTIVE
  To investigate whether severe loss of activities of daily living (ADL) in asylum-seeking children is associated with physical disease or toxic influences and to describe the clinical course during the recovery process.
  
  
  METHODS
  A total of 29 asylum-seeking children with severe loss of ADL were regularly assessed by physical examinations, laboratory tests and a structured evaluation of their ADL status during rehabilitation.
  
  
  RESULTS
  A total of 12 children had previously recorded suicide attempts and 21 were recorded to have experienced traumatic events in their country of origin. The mean time from turning point to recovery was 6 months. Of the study participants, 22 needed enteral feeding and 18 gained weight during recovery. All children had a pulse rate and systolic blood pressure within the normal range. No sign of intoxication or physical disease was identified in laboratory tests or clinical examinations, with the exception of one case of epilepsy.
  
  
  CONCLUSIONS
  Physical disease, pharmacological sedation or anorexia nervosa was not considered to be a probable cause of the loss of ADL in these children. The high rate of psychosocial risk factors and the stressful event of being in an asylum-seeking process call for further investigation of psychosomatic mechanisms.
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Sachs' Children's Hospital, Karolinska Institute, Stockholm, Sweden. bernice.aronsson@sodersjukhuset.se
authors.forename: B
authors.initials: B
authors.lastname: Aronsson
authors.forename: C
authors.initials: C
authors.lastname: Wiberg
authors.forename: P
authors.initials: P
authors.lastname: Sandstedt
authors.forename: A
authors.initials: A
authors.lastname: Hjern
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000856:Anorexia Nervosa / Q000175:diagnosis; D002648:Child; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D006993:Hypnotics and Sedatives / Q000097:blood / Q000652:urine; D007407:Interviews as Topic; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012036:Refugees / Q000523:psychology / Q000706:statistics & numerical data; D012046:Rehabilitation; D012307:Risk Factors; D012720:Severity of Illness Index; D013548:Sweden; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives