Pervasive refusal syndrome

Pervasive refusal syndrome is a severe, pervasive and life-threatening disorder. Most commonly seen in girls between the ages of 8 and 15, although also affecting boys and younger age groups, it is characterised by a profound and pervasive refusal to eat, drink, talk, walk and engage in any form of self-care. A determined resistance to treatment is a striking component of the condition. The causes are unclear, but likely to be complex, multiple and associated with a sense of hopelessness. Treatment needs to be comprehensive and is based on supporting the child in recovering at her own pace, while ensuring physical safety and well-being. The prognosis is good, provided treatment is appropriate, but recovery tends to take a year or more. Bryan Lask is Professor of Child and Adolescent Psychiatry at St George’s Hospital Medical School (Department of Psychiatry, Jenner Wing, Cranmer Terrace, London SW17 0RE, UK; e-mail: [email protected]). He has worked with early-onset eating disorders for over 20 years and has researched widely into these conditions. He has published over 100 scientific papers and 7 books, and has lectured around the world.