[Adolescent's refusal of school: a psychopathological aspect]

Despite the multiple studies on the school refusal phenomenon, clinical/psychopathological aspects of this problem need further studies. Authors performed a clinical/psychopathological analysis of the school refusal phenomenon in adolescents who are under supervision of a psychiatrist.

It were examined 223 adolescent patients (169 males and 54 females) with different appearances of school refusal.

A set of factors predisposing to school refusal (family system dysfunction, heritability, character features, psychological immaturity, demoralization syndrome) was identified. Psychopathological causes of school refusal were divided into school phobia (31.8%), protest reactions in the frames of developing disorders of excitable personality type (4.9%), signs of mood disorders (22.9%), schizophrenic process (14.4%) and symptoms of organic cognitive impairment (26%). The analysis of clinical/dynamic characteristics of school refusal in different clinical variants demonstrated the differences by gender, stereotype of development, cognitive function and the dynamics of the phenomenon per se.

In accordance to clinical variant of school refusal, we suggest to use differentiated therapeutic and preventive strategies.