Factors responsible for the prolongation of school refusal

Two hundred and one school refusers (less than or equal to 18 years old), e xcluding schizophrenia, were treated at the Department of Neuropsychiatry, Hirosaki University Hospital between April 1975 and March 1995. Of 56 cases of school refusal, 31 did not improve for more than 2 years (group P), and 25 cases had improved in the degree of school refusal and social impairmen t (group B). The remaining cases were excluded from the analysis for severa l reasons. There was no significant difference between groups B and P in ag e at the first psychiatric evaluation as well as the age of onset of school refusal. The duration from school absence to the first evaluation of group P was significantly longer than that of group B. The duration of school re fusal significantly and positively correlated with the duration from school absence to the first evaluation. Introversion and nervousness prolonged th e duration of school refusal. The non-presence of volition for school atten dance, and a low frequency of school attendance during the 1 month prior to the first evaluation influenced the prolongation of school refusal. The 'd uration from school absence to the first evaluation', the 'patient's charac ter', the 'non-presence of volition for school attendance' and the 'frequen cy of school attendance' influenced the prolongation of school refusal. The introduction of treatment within 10 months of the onset of school refusal is an important factor in preventing the prolongation of the school refusal .