School phobia

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School phobia or school avoidance or school refusal is a proposed mental illness. School phobia is vaguely defined and its validity has been challenged.[1][2]

Signs and symptoms[edit | edit source]

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

  • A child or adolescent fails to attend school, or very rarely attends

Sometimes the following criteria are also used, or may be assumed to be present:

  • 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[2][3][4]

Treatment[edit | edit source]

ME/CFS[edit | edit source]

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)."[5]

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.[6][7]

Misdiagnosis as school phobia[edit | edit source]

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."[1]

Notable studies[edit | edit source]

  • 2020, Severe ME in Children[8] - (Full text)
  • 2007, Special problems of children with myalgic encephalomyelitis/chronic fatigue syndrome and the enteroviral link[3] - (Full text)
  • 2007, Chronic Fatigue Syndrome in Children and Adolescents[5] - (Full text)
  • 2003, Learning and memorization impairment in childhood chronic fatigue syndrome manifesting as school phobia in Japan[4] - (Full Text)
  • 1995, The myth and the legend of school phobia[2] - (Abstract)

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. ↑ 1.0 1.1 Tyrrell, Maureen (June 2005). "School phobia". The Journal of School Nursing: The Official Publication of the National Association of School Nurses. 21 (3): 147–151. doi:10.1177/10598405050210030401. ISSN 1059-8405. PMID 15898849.
  2. ↑ 2.0 2.1 2.2 Kearney, Christopher A.; Eisen, Andrew R.; Silverman, Wendy K. (1995). "The legend and myth of school phobia". School Psychology Quarterly. 10 (1): 65–85. doi:10.1037/h0088293. ISSN 1939-1560.
  3. ↑ 3.0 3.1 Colby, J (February 2007). "Special problems of children with myalgic encephalomyelitis/chronic fatigue syndrome and the enteroviral link". Journal of Clinical Pathology. 60 (2): 125–128. doi:10.1136/jcp.2006.042606. ISSN 0021-9746. PMC 1860612. PMID 16935964.
  4. ↑ 4.0 4.1 Miike, Teruhisa; Tomoda, Akemi; Jhodoi, Takako; Iwatani, Noritaka (October 1, 2004). "Learning and memorization impairment in childhood chronic fatigue syndrome manifesting as school phobia in Japan". Brain and Development. 26 (7): 442–447. doi:10.1016/j.braindev.2003.10.004. ISSN 0387-7604. PMID 15351079.
  5. ↑ 5.0 5.1 Underhill, Rosemary (2007). "Chronic Fatigue Syndrome in Children and Adolescents" (PDF). New Jersey Chronic Fatigue Syndrome Association, Inc.
  6. ↑ Rowe, Peter C.; Underhill, Rosemary A.; Friedman, Kenneth J.; Gurwitt, Alan; Medow, Marvin S.; Schwartz, Malcolm S.; Speight, Nigel; Stewart, Julian M.; Vallings, Rosamund; Rowe, Katherine S. (2017). "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer". Frontiers in Pediatrics. 5 (121). doi:10.3389/fped.2017.00121.
  7. ↑ Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
  8. ↑ Speight, Nigel (2020). "Severe ME in Children". Healthcare. 8 (3): 211. doi:10.3390/healthcare8030211.

enterovirus A genus of RNA viruses which typically enter the body through the respiratory or gastrointestinal systems and sometimes spread to the central nervous system or other parts of the body, causing neurological, cardiac, and other damage. Since the first reports of myalgic encephalomyelitis (ME), enteroviruses have been suspected as a cause of ME. Enteroviruses have also been implicated as the cause of Type I diabetes, congestive heart failure, and other conditions. Enteroviruses include poliovirus, coxsackieviruses, and many others. New enteroviruses and new strains of existing enteroviruses are continuously being discovered. (Learn more: viralzone.expasy.org)

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

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