Functional Outcome of Adolescents with ‘School Refusal’

Abstract

There is limited information about the outcome of young people with school refusal. We aimed to describe the functional outcomes of persons with school refusal presenting to a child and adolescent psychiatric unit. Young people assessed or treated for school refusal between 1994 and 1998 at the Rivendell Unit, Sydney, Australia, were identified. Information was gathered from the medical records, mailed questionnaires and follow-up telephone interviews. Of 192 patients eligible for inclusion in the study, outcome information was available for 118 (61%); 83 had improved functional outcomes (employment and/or education) at 6 months after treatment and 89 at 3 years after treatment. Dysthymia or comorbid diagnoses were associated with poorer functional outcomes 6 months after treatment/assessment, but not at 3 years. The longer term functional outcomes for those treated for school refusal, apart from those with social phobia or academic difficulties, were favourable. Diagnoses of social phobia and learning difficulties were predictive of poorer functional outcomes 3 years after treatment. Longer or more intensive treatment of those with social phobia may improve outcome.