Pervasive refusal syndrome

Pervasive refusal syndrome (PRS), also known as pervasive arousal withdrawal syndrome (PAWS), is a mental disorder in children. Children with the disorder abandon their involvement in all phases of their life. It is characterized by refusal to eat, drink, talk, walk or self-care, and a firm resistance to treatment. PRS starts slowly, but the child then worsens quickly becoming reluctant or not capable to do anything for themselves. They are very depressed and distraught. Pervasive refusal syndrome (PRS), also known as pervasive arousal withdrawal syndrome (PAWS), is a mental disorder in children. Children with the disorder abandon their involvement in all phases of their life. It is characterized by refusal to eat, drink, talk, walk or self-care, and a firm resistance to treatment. PRS starts slowly, but the child then worsens quickly becoming reluctant or not capable to do anything for themselves. They are very depressed and distraught. Its cause is unclear. The disorder usually begins with a 'virus', or the child having a 'pain', even though no substantial cause can be found. A family with a psychiatric history or environmental stress factors can also play a role. It is not included in the standard psychiatric classification systems. Hospitalization is almost always necessary and the recovery period is typically more than a year. During the recovery period symptoms disappear in the opposite order they appear. About 67% of the cases show complete recovery. Nevertheless, once the person is healthy, relapse is very infrequent. PRS is rare. It was first described by Bryan Lask and colleagues in 1991. The charity Invest in ME says that children who are initially diagnosed with the serious illness myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS), which is typically triggered by a virus, may have their illness label changed to the flawed diagnosis of pervasive refusal syndrome if their doctors do not believe that ME/CFS really exists, or if these doctors do not accept that children with ME/CFS can be so seriously ill that they need tube feeding. PRS symptoms have common characteristics with many other psychiatric disorders. However, none of the present DSM diagnoses can account for the full scope of symptoms seen in PRS, and refusal to eat, weight loss, social withdrawal and school refusal can be considered as the main distinctive features. Any system may be involved, however some more commonly engaged than others. Gastrointestinal: Neurological: Musculoskeletal: Autism is a neural development disorder defined by flawed social interaction and communication, and by restricted and repetitive behavior. The patient with autism displays substantial deficit in all three core deficits of PRS which include: impairments in social interaction, impairments in communication, and restricted and stereotyped patterns of behavior, interests, and activities.