Pervasive refusal syndrome - A clinical challenge

Area of Science:

• Neuroscience
• Child Psychiatry
• Clinical Case Study

Background:

• Pervasive refusal syndrome (PRS) is characterized by multifaceted refusal, social withdrawal, and treatment resistance.
• While often associated with depressive features and eating disorder-like traits, PRS typically has a good prognosis with 67% recovery rates.
• Organic causes are undetectable in PRS, yet it remains a potentially life-threatening condition.

Observation:

• This report details the first case of Pervasive Refusal Syndrome from India in a child presenting with severe neuropsychiatric symptoms.
• The child exhibited profound refusal across multiple domains and significant resistance to therapeutic interventions.

Findings:

• Despite treatment with electroconvulsive therapy (ECT) and pharmacotherapy, the child experienced a fatal outcome.
• While PRS typically shows a high recovery rate (67%), this case underscores the potential for severe, adverse outcomes.

Implications:

• This case highlights the critical need for early recognition and aggressive management strategies for Pervasive Refusal Syndrome in pediatric populations.
• Further research is warranted to understand risk factors and optimize treatment protocols for PRS, particularly in diverse geographical and clinical settings.