School phobia

School phobia or school avoidance or school refusal is a proposed mental illness. School phobia is vaguely defined and its validity has been challenged.

Signs and symptoms
No diagnostic criteria have been established, but the following are generally described:

Sometimes the following criteria are also used, or may be assumed to be present:
 * A child or adolescent fails to attend school, or very rarely attends
 * Lack of attendance cannot be explained (or is not fully explained) by illness
 * The child or adolescent is afraid to attend school or intentionally tries to avoid attending

ME/CFS
Dr Rosemary Underhill stated tjat children with ME/CFS may be wrongly considered to have a mental or behavioral disorder if they are too ill to attend school regularly:

"'ME/CFS has often been misdiagnosed, as School Avoidance Behavior, or as Munchausen's syndrome by proxy (a condition in which, a parent fabricates their child's illness).'"

ME/CFS has been found to cause significant absence from school, and studying at home can be seriously affected by cognitive dysfunction including difficulty learning new things, memory problems and poor concentration. 

Misdiagnosis as school phobia
Tyrrell (2005) describes a particularly common combination of childhood ME/CFS symptoms as school phobia, stating: "'Hiding behind such common physical symptoms as headaches, stomachaches, and fatigue, school phobia evades diagnosis with ease.'"

Notable studies

 * 2020, Severe ME in Children - (Full text)
 * 2007, Special problems of children with myalgic encephalomyelitis/chronic fatigue syndrome and the enteroviral link - (Full text)
 * 2007, Chronic Fatigue Syndrome in Children and Adolescents - (Full text)


 * 2003, Learning and memorization impairment in childhood chronic fatigue syndrome manifesting as school phobia in Japan - (Full Text)
 * 1995, The myth and the legend of school phobia - (Abstract)