Centre for Research Ethics and Bioethics (CRB), Uppsala University, P.O. Box 564, 751 22, Uppsala, Sweden.
K8, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
Eur Child Adolesc Psychiatry. 2023 Jan;32(1):75-86. doi: 10.1007/s00787-021-01833-3. Epub 2021 Jul 5.
Despite poor treatment results, a family-oriented approach and the securing of residency have been deemed essential to recovery from resignation syndrome (RS). In a retrospective cohort study, we evaluated an alternative method involving environmental therapy, with patients separated from their parents, while actively abstaining from involving the asylum process in treatment. We examined medical records, social services acts, and residential care home acts from 13 individuals treated at Solsidan residential care home between 2005 and 2020. Severity and outcome were assessed with Clinical Global Impression, Severity and Improvement subscales. Thirteen participants were included and out of these nine (69%) recovered, i.e. they very much or much improved. Out of the eight that were separated, all recovered, also, one non-separated recovered. The difference in outcome between subjects separated and not was significant (p = 0.007). Moreover, out of the five which received a residency permit during treatment, one recovered whereas four did not. The difference in outcome between subjects granted residency and not was significant (p = 0.007). The data revealed three (23%) cases of simulation where parents were suspected to have instigated symptoms. Our evaluation suggests that separation from parents and abstaining from invoking residency permit could be essential components when treating RS. Relying on a family-oriented approach, and residency could even be detrimental to recovery. The examined intervention was successful also in cases of probable malingering by proxy.
尽管治疗效果不佳，但家庭导向的方法和确保居留权被认为是从辞职综合征 (RS) 中恢复的关键。在一项回顾性队列研究中，我们评估了一种替代方法，涉及环境治疗，让患者与父母分开，同时积极避免在治疗中涉及庇护程序。我们检查了 2005 年至 2020 年间在 Solsidan 寄宿护理院接受治疗的 13 个人的病历、社会服务行为和住宿护理院行为。使用临床总体印象、严重程度和改善子量表评估严重程度和结果。共纳入 13 名参与者，其中 9 名（69%）康复，即他们非常或大大改善。在这 8 名被隔离的患者中，所有患者都康复了，还有 1 名未被隔离的患者康复了。被隔离和未被隔离的患者之间的结果差异有统计学意义（p=0.007）。此外，在治疗过程中获得居留许可的 5 名患者中，1 名康复，4 名未康复。给予居留许可和未给予居留许可的患者之间的结果差异有统计学意义（p=0.007）。数据显示有 3 例（23%）疑似父母教唆症状的模拟病例。我们的评估表明，与父母分开并避免申请居留许可可能是治疗 RS 的重要组成部分。依赖家庭导向的方法和居留许可甚至可能对康复有害。所检查的干预措施在可能的代理装病病例中也取得了成功。
