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Pervasive refusal syndrome
Pervasive refusal syndrome (PRS) now referred to as Pervasive arousal withdrawal syndrome (PAWS) is a rare but serious child psychiatric disorder that was first described by Bryan Lask and colleagues in 1991.〔 As of 2011, it is not included in the standard psychiatric classification systems.〔 PRS is the name allotted to a disorder in which children have abandoned their involvement in all phases of their life. It's characterized by refusal to eat, drink, talk, walk or self-care, and a firm resistance to treatment. PRS is very rare and its cause is unclear, but its severity makes it life-threatening. The disorder usually begins with a 'virus', or the child having a 'pain', that results in the need for consulting a doctor or going to the hospital, even though no substantial cause can be found. PRS starts slowly, but the child then worsens quickly becoming reluctant or not capable to do anything for themselves.〔 They originally refuse to accept others caring for them, or helping them eat, and are very depressed and distraught. It is not guaranteed that recovery will take place, and it is a lengthy and complex process, involving specialist medical care.〔 Nevertheless, once the patient is healthy, relapse is very infrequent.
A family with a psychiatric history or environmental stress factors can also play a role. Hospitalization is almost always necessary and the recovery period is lengthy; typically 12.8 months. During the recovery period symptoms disappear in the opposite order they appear. About 67% of the cases show complete recovery.〔
PRS may be linked to learned helplessness, and so it can be important for the patient to be able to manage the rate of their recovery. Music therapy may help in this regard as it provides empowerment by giving the patient choice and control, while allowing for improvisation can result in a sense of affirmation and validation; all important for a successful recovery.〔
==Epidemiology==
Pervasive refusal syndrome is for the most part frequently seen in girls and less so in boys. The average age of onset is between the ages of 7 and 15.〔 Affected children are usually high achievers with high self-expectations, fears of failure, and difficulty dealing with failure to achieve personal standards. The onset of PRS is usually acute.〔
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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