Tuesday, July 12, 2011
Let's ignore the evidence of autoimmune serology in a 14-year old boy and call it Pervasive Refusal Syndrome
Clin Child Psychol Psychiatry. 2011 Jul 6. [Epub ahead of print]
Wright B, Beverley D.:
Child, Adolescent & Family Unit, York, England.
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.
My PS: is ignoring clinical evidence flavour of the month in the UK or so, or should that be flavour of the decade professor?
See also: Is ignoring clinical evidence The Way Ahead for the RCGP and Prof Christopher Ward ?