[School refusal: classification, developmental psychopathology, prognosis and therapeutic approaches]

In many cases the refusal of school is one manifestation of a complex psychiatric disorder. There is an increased comorbidity with depression, phobia and other anxiety disorders. The program of therapy should be conceptualized as multimodal. In general there is no rapid remission of the symptoms. As catamnestic studies proved, long-term consequences should be anticipated concerning the occupational integration as well as further psychiatric morbidity. Triggering and sustainable factors are heterogeneous and there is no typical psychosocial pattern.