Mouren Marie-Christine, Delorme Richard
Service de Psychopathologie de l'enfant et de l'adolescent, Hôpital Robert Debré, Paris 75019.
Bull Acad Natl Med. 2006 Nov;190(8):1629-39; discussion 1639-41.
For some time the concept of "school phobia" has been associated with anxiety disorders in children and adolescents, and especially with separation anxiety. The scope of this concept is now being broadened to include other underlying disorders such as antisocial disorders and behaviors such as school truancy, which were previously among the differential diagnoses. The term "school refusal" is now preferred in the literature, being more in line with reports of increasingly complex patient and family situations. This article reviews the main clinical, psychopathological and therapeutic dimensions of school refusal. The aims are to increase child-health professionals' awareness of this disorder and to describe a treatment plan centered on school attendance. Indeed, early detection and appropriate treatment can considerably improve these children's outcome.
一段时间以来,“学校恐惧症”这一概念一直与儿童和青少年的焦虑症相关联,尤其是与分离焦虑有关。现在,这一概念的范围正在扩大,以包括其他潜在疾病,如反社会障碍,以及诸如逃学等行为,这些以前都属于鉴别诊断的范畴。目前,文献中更倾向使用“学校拒学”这一术语,因为它更符合日益复杂的患者和家庭情况的报告。本文回顾了学校拒学的主要临床、心理病理和治疗方面。目的是提高儿童健康专业人员对这种疾病的认识,并描述一个以到校上课为中心的治疗计划。事实上,早期发现和适当治疗可以显著改善这些儿童的预后。