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Advances in Psychiatric Treatment (2004) 10: 153-159
© 2004 The Royal College of Psychiatrists

Pervasive refusal syndrome

Bryan Lask

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: blask{at}sghms.ac.uk). 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.

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.




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