Highlights the diagnostic conundrum of pervasive refusal syndrome and the importance of considering differential diagnoses like catatonia which respond rapidly to treatment.
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May prompt consideration of catatonia in pervasive refusal syndrome; case reports leave open systematic diagnostic validation.
A case is presented of an 11-year-old girl with pervasive refusal syndrome (PRS) who ultimately recovered acutely and completely after an 18-month paediatric hospitalisation. There was an apparent absence of previously proposed important aetiological factors in PRS, such as family pathology and markedly traumatic or abusive experiences, and her recovery was sudden and complete. The authors consider the differential diagnoses of PRS paying particular attention to the possibility of a conversion disorder or catatonia, given the absence of PRS in the North American literature. Consideration of catatonia is important as it has a diagnostic test and responds rapidly to appropriate treatment, in contrast to conventional treatment for PRS and conversion disorder.
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McNicholas et al. (2012) studied this question.
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