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School Refusal: Clinical Features, Diagnosis and Treatment

Yıl 2010, Cilt: 2 Sayı: 3, 362 - 383, 01.09.2010

Öz

Children regularly and voluntarily go to school in order to fulfill the expectations of society from them to continue their education or schooling. School continuation has been made compulsory by laws. Nonetheless, contrary to popular belief, for some children it is distressing to go to school. These children have difficulty continuing school and/or refuse to go to school. Today school refusal is defined as a child's inability to continue school for reasons, such as anxiety and depression. The prevalence of school refusal has been reported to be approximately 1% in school-age children and 5% in child psychiatry samples. The prevalence of school refusal is similar among boys and girls. School refusal can occur at any time throughout the child's academic life and at all socio-economic levels. School refusal is considered a symptom rather than a clinical diagnosis and can manifest itself as a sign of many psychiatric disorders, with anxiety disorders predominant. Separation anxiety disorder, generalized anxiety disorder, social phobia, specific phobia, and adjustment disorder with anxiety symptoms are the most common disorders co-occurring with school refusal. While separation anxiety disorder is associated with school refusal in younger children, other anxiety disorders, especially phobias, are associated with school refusal in adolescents. Children who have parents with psychiatric disorders have a higher incidence of school refusal, and psychiatric disorders are more frequently seen in adult relatives of children with school refusal, which supports a significant role of genetic and environmental factors in th etiology of school refusal. School refusal is a emergency state for child mental health. As it leads to detrimental effects in the short term and the long term, it should be regarded as a serious problem. The long-lasting follow-up studies of school refusing children have revealed that these children have a higher incidence of psychiatric disorders or that they are more likely to require psychological assistance. It is for these reasons that the treatment of school refusal is increasingly gaining impor-tance. The major aim of the treatment is to help the child return to school at the shortest time possible. The treatment should be carried out in cooperation with the child's parents and the school personnel. A widely accepted approach to the treatment of school refusal is one that is concerned with the application of a multi-faceted treatment. Psychosocial and psychopharmacological approaches constitute the crucial parts of the therapeutic process. Today, cognitive behaviour therapy and medication are the most frequently employed approaches in the treatment of school refusal.

Kaynakça

  • Holzer L, Halfon O. The school refusal. Arch Pediatr 2006; 13:1252-1258.
  • Broadwin IT. A contribution to the study of truancy. Am J Orthopsychiatry 1932; 2:253-259.
  • Johnson AM, Falstein EI, Szurek SA, Svendsen M. School phobia. Am J Orthopsychiatry 1941; 11:702-711.
  • Hersov LA. Refusal to go to school. J Child Psychol Psychiatry 1960; 1:137-145.
  • King N, Bernstein GA. School refusal in children and adolescents: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 2001; 40:197–205.
  • Egger HL, Costello EJ, Angold A. School refusal and psychiatric disorders: a community study. J Am Acad Child Adolesc Psychiatry 2003; 42:797-807.
  • Bowlby J. Attachment and Loss, Separation Anxiety and Anger. New York, Basic Books, 1973.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) 4th Ed. Washington, American Psychiatric Association, 1994.
  • Berg I, Nichols K, Pritchard C. School phobia: its classification and relationship to dependency. J Child Psychol Psychiatry 1969; 10:123–141.
  • Berg I. Absence from school and mental health. Br J Psychiatry 1992; 161:154–166.
  • Kearney CA, Silverman WK. Family environment of youngsters with school refusal behavior: a synopsis with implications for assessment and treatment. Am J Fam Ther 1995; 23:59–72.
  • Gordon DA, Young RD. School phobia: a discussion of aetiology, treatment and evaluation. Psychol Rep 1976; 39:783-804.
  • Galloway D. Truants and other absentees. J Child Psychol Psychiatry 1983; 24:607- 611.
  • Berg I. School avoidance, school phobia, and truancy. In Child and Adolescent Psychiatry: A Comprehensive Textbook (Ed M Lewis): 1104-1110. Baltimore, Williams and Wilkins, 1996.
  • Hersov L. School refusal. In Child and Adolescent Psychiatry: Modern Approaches, 2nd Ed. (Eds M Rutter, L Hersov): 382-389. Oxford, Blackwell, 1985.
  • Kahn JH, Nursten JP. School refusal: a comprehensive view of school phobia and other failures of school attendance. Am J Orthopsychiatry 1962; 32:707-718.
  • Last CG, Francis G. School phobia. In Advances In Clinical Child Psychology (Eds BB Lahey, AE Kazdin): 193-222. New York, Plenum Pres, 1988.
  • Burke AE, Silverman WK. The prescriptive treatment of school refusal. Clin Psychol Rev 1987; 7:353-362.
  • Last CG, Strauss CC. School refusal in anxiety-disordered children and adolescents. J Am Acad Child Adolesc Psychiatry 1990; 29:31-35.
  • Ollendick TH, Mayer JA. School phobia. In Behavioral Treatment of Anxiety Disorders (Ed SM Turner): 367-411. New York, Plenum Pressi 1984.
  • Honjo S, Kasahara Y, Ohtaka K. School refusal in Japan. Acta Paedopsychiatr 1992; 55:29-32.
  • Granell de Aldaz E, Vivas E, Gelfand DM, Feldman L. Estimating the prevalence of school refusal and school-related fears. A Venezuelan sample. J Nerv Ment Dis 1984;
  • Heyne D, King NJ, Tonge BJ, Cooper H. School refusal: Epidemiology and management. Paediatr Drugs 2001; 3:719-732.
  • Smith SL. School refusal with anxiety: A review of 63 cases. Can Psychiat Ass J 1970; 15:257-264.
  • Bahalı K, Tahiroğlu AY, Avcı A. Okul reddi olan çocuk ve ergenlerin klinik özellikleri. Anadolu Psikiyatri Dergisi 2009; 10:310-317.
  • Kearney CA, Eisen AR, Silverman WK. The legend and myth of school phobia. Sch Psychol Q 1995; 10: 65-85.
  • Last CG. Anxiety disorders in childhood and adolescence. In Internalizing Disorders in Children and Adolescents (Ed WM Reynolds): 61-106. New York, John Wiley, 1992.
  • Last CG, Francis G, Hersen M, Kazdin AE, Strauss CC. Separation anxiety and school phobia: a comparison using DSM-III criteria. Am J Psychiatry 1987; 144:653-657.
  • Hersov L. School refusal. In Child and Adolescent Psychiatry: Modern Approaches (Eds M Rutter, L Hersov): 455-486. Oxford, Blackwell, 1977.
  • Hersov L. School refusal: An overview. In Why Children Reject School Views from Seven Countries (Eds C Chiland, JG Yound): 16-41. New Haven, Yale University Press, 1990.
  • Bahalı K. Okul reddi olan çocuk ve ergenlerin ailesel özellikleri (Uzmanlık tezi). Adana, Çukurova Üniversitesi, 2008.
  • Elliott JG. School refusal: Issues of conceptualisation, assessment, and treatment. J Child Psychol Psychiat 1999; 40:1001-1012.
  • Torma S, Halsti A. Factors contributing to school phobia and truancy. Psychiatria Fennica 1975; 75:209-220.
  • Berg I. School refusal in early adolescence. In Out of School: Modern Perspectives (Eds L Hersov, I Berg): 231-249. Chichester, John Wiley, 1980.
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Okul Reddi: Klinik Özellikler, Tanı ve Tedavi

Yıl 2010, Cilt: 2 Sayı: 3, 362 - 383, 01.09.2010

Öz

Toplumun eğitim ve okula devam etme gibi beklentilerini karşılamak için çocuklar düzenli ve gönüllü olarak okula gitmektedir. Okula devam etme yasalar ile de zorunlu hale getirilmiştir. Bununla birlikte, bazı çocuklar için okula gitmek beklenenin ötesinde sıkıntı verici bir durumdur. Bu çocuklar okula devam etmede güçlük çekmekte ve/veya okula gitmeyi reddetmektedir. Günümüzde okul reddi, çocukların anksiyete ve depresyon gibi duygusal sorunlar nedeni ile okula devam edememesi olarak tanımlanmaktadır. Okul reddinin yaygınlığı tüm okul çağındaki çocuklar için yaklaşık % 1 ve kliniğe başvuran tüm çocuklar için % 5 olarak bildirilmektedir. Okul reddi erkek ve kız çocuklarda eşit oranda görülmektedir. Okul hayatının herhangi bir döneminde ortaya çıkabilmektedir. Okul reddinin tüm sosyoekonomik düzeylerde görülebildiği bildirilmektedir. Okul reddi klinik bir tanı olmayıp bir belirti olarak değerlendirilmektedir. Anksiyete bozuklukları başta olmak üzere birçok ruhsal bozukluğun belirtisi olabilmektedir. Ayrılma anksiyetesi bozukluğu, yaygın anksiyete bozukluğu, sosyal fobi, özgül fobi ve anksiyete ile giden uyum bozukluğu okul reddi ile birlikte en sık görülen tanılardır. Tanılarda yaşa bağlı eğilimler görülmektedir. Ayrılma anksiyetesi bozukluğu genelde yaşça daha küçük çocuklardaki okul reddi ile ilişkilendirilirken, diğer anksiyete bozuklukları özellikle de fobiler ergenlerdeki okul reddi ile ilişkilendirilmektedir. Ruhsal bozukluğu olan ebeveynlerin çocuklarında okul reddi sık görülmektedir. Bu, genetik ve çevresel faktörlerin okul reddi gelişimindeki rolünü desteklemektedir. Okul reddi bir çocuk ruh sağlığı acilidir. Kısa ve uzun dönemde olumsuz sonuçlar doğurduğu için ciddi bir sorun olarak değerlendirilmektedir. Okul reddi olan çocukların uzun süreli izlem çalışmalarında, genel toplum ya da kontrol gruplarına göre daha yüksek oranda ruhsal bozuklukların bulunduğu ya da ruhsal yardıma gereksinim duyma olasılıklarının daha yüksek olduğu gösterilmiştir. Bu nedenlerden dolayı okul reddinin tedavisi çok önem kazanmaktadır. Tedavide temel amaç çocuğun en kısa süre içerisinde okula dönmesini sağlamaktır. Tedavi ebeveyn ve okul personeli ile işbirliği içinde yürütülmelidir. Tedavide genel kabul gören yöntem çok eksenli bir tedavi yaklaşımı uygulamaktır. Psikososyal ve psikofarmakolojik yaklaşımlar tedavinin önemli ayaklarını oluşturur. Günümüzde bilişsel davranışçı terapi ve ilaç sağaltımı tedavide en sık kullanılan yaklaşımlar olarak öne çıkmaktadır.

Kaynakça

  • Holzer L, Halfon O. The school refusal. Arch Pediatr 2006; 13:1252-1258.
  • Broadwin IT. A contribution to the study of truancy. Am J Orthopsychiatry 1932; 2:253-259.
  • Johnson AM, Falstein EI, Szurek SA, Svendsen M. School phobia. Am J Orthopsychiatry 1941; 11:702-711.
  • Hersov LA. Refusal to go to school. J Child Psychol Psychiatry 1960; 1:137-145.
  • King N, Bernstein GA. School refusal in children and adolescents: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 2001; 40:197–205.
  • Egger HL, Costello EJ, Angold A. School refusal and psychiatric disorders: a community study. J Am Acad Child Adolesc Psychiatry 2003; 42:797-807.
  • Bowlby J. Attachment and Loss, Separation Anxiety and Anger. New York, Basic Books, 1973.
  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) 4th Ed. Washington, American Psychiatric Association, 1994.
  • Berg I, Nichols K, Pritchard C. School phobia: its classification and relationship to dependency. J Child Psychol Psychiatry 1969; 10:123–141.
  • Berg I. Absence from school and mental health. Br J Psychiatry 1992; 161:154–166.
  • Kearney CA, Silverman WK. Family environment of youngsters with school refusal behavior: a synopsis with implications for assessment and treatment. Am J Fam Ther 1995; 23:59–72.
  • Gordon DA, Young RD. School phobia: a discussion of aetiology, treatment and evaluation. Psychol Rep 1976; 39:783-804.
  • Galloway D. Truants and other absentees. J Child Psychol Psychiatry 1983; 24:607- 611.
  • Berg I. School avoidance, school phobia, and truancy. In Child and Adolescent Psychiatry: A Comprehensive Textbook (Ed M Lewis): 1104-1110. Baltimore, Williams and Wilkins, 1996.
  • Hersov L. School refusal. In Child and Adolescent Psychiatry: Modern Approaches, 2nd Ed. (Eds M Rutter, L Hersov): 382-389. Oxford, Blackwell, 1985.
  • Kahn JH, Nursten JP. School refusal: a comprehensive view of school phobia and other failures of school attendance. Am J Orthopsychiatry 1962; 32:707-718.
  • Last CG, Francis G. School phobia. In Advances In Clinical Child Psychology (Eds BB Lahey, AE Kazdin): 193-222. New York, Plenum Pres, 1988.
  • Burke AE, Silverman WK. The prescriptive treatment of school refusal. Clin Psychol Rev 1987; 7:353-362.
  • Last CG, Strauss CC. School refusal in anxiety-disordered children and adolescents. J Am Acad Child Adolesc Psychiatry 1990; 29:31-35.
  • Ollendick TH, Mayer JA. School phobia. In Behavioral Treatment of Anxiety Disorders (Ed SM Turner): 367-411. New York, Plenum Pressi 1984.
  • Honjo S, Kasahara Y, Ohtaka K. School refusal in Japan. Acta Paedopsychiatr 1992; 55:29-32.
  • Granell de Aldaz E, Vivas E, Gelfand DM, Feldman L. Estimating the prevalence of school refusal and school-related fears. A Venezuelan sample. J Nerv Ment Dis 1984;
  • Heyne D, King NJ, Tonge BJ, Cooper H. School refusal: Epidemiology and management. Paediatr Drugs 2001; 3:719-732.
  • Smith SL. School refusal with anxiety: A review of 63 cases. Can Psychiat Ass J 1970; 15:257-264.
  • Bahalı K, Tahiroğlu AY, Avcı A. Okul reddi olan çocuk ve ergenlerin klinik özellikleri. Anadolu Psikiyatri Dergisi 2009; 10:310-317.
  • Kearney CA, Eisen AR, Silverman WK. The legend and myth of school phobia. Sch Psychol Q 1995; 10: 65-85.
  • Last CG. Anxiety disorders in childhood and adolescence. In Internalizing Disorders in Children and Adolescents (Ed WM Reynolds): 61-106. New York, John Wiley, 1992.
  • Last CG, Francis G, Hersen M, Kazdin AE, Strauss CC. Separation anxiety and school phobia: a comparison using DSM-III criteria. Am J Psychiatry 1987; 144:653-657.
  • Hersov L. School refusal. In Child and Adolescent Psychiatry: Modern Approaches (Eds M Rutter, L Hersov): 455-486. Oxford, Blackwell, 1977.
  • Hersov L. School refusal: An overview. In Why Children Reject School Views from Seven Countries (Eds C Chiland, JG Yound): 16-41. New Haven, Yale University Press, 1990.
  • Bahalı K. Okul reddi olan çocuk ve ergenlerin ailesel özellikleri (Uzmanlık tezi). Adana, Çukurova Üniversitesi, 2008.
  • Elliott JG. School refusal: Issues of conceptualisation, assessment, and treatment. J Child Psychol Psychiat 1999; 40:1001-1012.
  • Torma S, Halsti A. Factors contributing to school phobia and truancy. Psychiatria Fennica 1975; 75:209-220.
  • Berg I. School refusal in early adolescence. In Out of School: Modern Perspectives (Eds L Hersov, I Berg): 231-249. Chichester, John Wiley, 1980.
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  • Buitelaar JK, Van Andel H, Duyx JH, Van Strien DC. Depressive and anxiety disorders in adolescence: a follow-up study of adolescents with school refusal. Acta Paedopsychiatr 1994; 56:249-253.
  • Masi G, Mucci M, Millepiedi S. Separation anxiety disorder in children and adolescents: Epidemiology, diagnosis and management. CNS Drugs 2001; 15:93-104.
  • Türkbay T, Söhmen T. Ayrılık kaygısı bozukluğunda bireysel ve ailesel etmenler. Çocuk ve Gençlik Ruh Sağlığı Dergisi 2001; 8:77-84.
  • Prabhuswamy M, Srinath S, Girimaji S, Seshadri S. Outcome of children with school refusal. Indian J Pediatr 2007; 74:375-379.
  • Heyne D. Evaluation of child therapy and caregiver training in the treatment of school refusal (Thesis). Melbourne, University of Monash, 1999.
  • Hoshino Y, Nikkuni S, Kaneko M, Endo M, Yashima Y, Kumashiro H. The application of DSM-III diagnostic criteria to school refusal. Jpn J Psychiatry Neurol 1987; 41:1-7.
  • King NJ, Ollendick TH. School refusal: graduated and rapid behavioural treatment strategies. Aust NZ J Psychiatry 1989; 23:213-223.
  • Last CG, Strauss CC, Francis G. Comorbidity among childhood anxiety disorders. J Nerv Ment Dis 1987; 175:726-730.
  • Naylor MW, Staskowski M, Kenney MC, King CA. Language disorders and learning disabilities in school-refusing adolescents. J Am Acad Child Adolesc Psychiatry 1994; 33:1331-1337.
  • Merikangas KR, Swendsen J. Genetic epidemiology of psychiatric disorders. Epidemiol Rev 1997; 19:144-155.
  • Smoller JW, Finn C, White C. The genetics of anxiety disorders: an overview. Psychiatr Ann 2000; 30:745-753.
  • Turner SM, Beidel BC, Epstein LH. Vulnerability and risk for anxiety disorders. J Anxiety Disord 1991; 5:151-166.
  • Maier W, Lichtermann D, Minges J, Oehrlein A, Franke P. A controlled family study in panic disorder. J Psychiatr Res 1993; 27(Suppl.1):S79-S87.
  • Gorwood P, Feingold J, Ades J. Epidemiologie genetique et psychiatrie(I): portees et limites des etudes de concentration familiale exemple du trouble panique. Encephale 1999; 10:21-29.
  • Noyes R, Woodman C, Garvey MJ, Cook BL, Suelzer M, Clancy J et al. Generalized anxiety disorder vs. panic disorder: distinguishing characteristics and patterns of comorbidity. J Nerv Ment Dis 1992; 180:369-379.
  • Mendlewicz J, Papdimitriou G, Wilmotte J. Family study of panic disorder: comparison with generalized anxiety disorder, major depression and normal subjects. Psychiatr Genet 1993; 3:73-78.
  • Pauls DL, Alsobrook JP, Goodman W, Rasmussen S, Leckman JF. A family study of obsessive-compulsive disorder. Am J Psychiatry 1995; 152:76-84.
  • Nestadt G, Samuels J, Riddle M, Bienvenu OJ, Liang KY, LaBuda M et al. A family study of obsessive-compulsive disorder. Arch Gen Psychiatry 2000; 57:358-363.
  • Calvo R, Lazaro L, Castro J, Morer A, Toro J. Parental psychopathology in child and adolescent obsessive-compulsive disorder. Soc Psychiatry Psychiatr Epidemiol 2007; 42:647-655.
  • Fyer AJ, Mannuzza S, Chapman T, Martin LY, Klein DF. Specificity in familial aggregation of phobic disorders. Arch Gen Psychiatry 1995; 52:564-573.
  • Stein M, Chartier MJ, Hazen AL, Kozak MV, Tancer ME, Lander S et al. A direct interview family study of generalized social phobia. Am J Psychiatry 1998; 155:90-97.
  • Smoller JW, Tsuang MT. Panic and phobic anxiety: defining phenotypes for genetic studies. Am J Psychiatry 1998; 155:1152-1162.
  • Cooper PJ, Fearn V, Willetts L, Seabrook H, Parkinson M. Affective disorder in the parents of a clinic sample of children with anxiety disorders. J Affect Disord 2006; 93:205-212.
  • McClure EB, Brennan PA, Hammen C, Le Brocque RM. Parental anxiety disorders, child anxiety disorders, and the perceived parent–child relationship in an Australian high-risk sample. J Abnorm Child Psychol 2001; 29:1-10.
  • Connell AM, Goodman SH. The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: a metaanalysis. Psychol Bull 2002; 128:746-773.
  • Martin C, Cabrol S, Bouvard MP, Lepine JP, Mouren-Simeoni MC. Anxiety and depressive disorders in fathers and mothers of anxious school-refusing children. J Am Acad Child Adolesc Psychiatry 1999; 38:916-922.
  • Özcan Ö. Okul reddi olan çocuklarda ve anne babalarında ruhsal bozukluklar (Uz- manlık tezi). Ankara, Ankara Üniversitesi, 2004.
  • Unnevehr S, Schneider S, Florin I, Margraf J. Psychopathology in children of patients with panic disorder or animal phobia. Psychopathology 1998; 31:69-84.
  • Beidel D, Turner SM. At risk for anxiety: I. Psychopathology in the offspring of anxious patients. J Acad Child Adolesc Psychiatry 1997; 36:918-924.
  • Biederman J, Faraone SV, Hirshfeld-Becker DR, Friedman D, Robin JA, Rosenbaum JF. Patterns of psychopathology and dysfunction in high-risk children of parents with panic disorder and major depression. Am J Psychiatry 2001; 158:49-57.
  • Taner Y. Obsesif kompulsif bozukluk ve panik bozukluğu olan annelerin çocuklarında psikopatoloji (Uzmanlık tezi). Ankara, Hacettepe Üniversitesi, 2003.
  • Bernstein GA, Garfinkel BD. Pedigrees, functioning and psychopathology in families of school phobic children. Am J Psychiatry 1988; 145:70-74.
  • Bernstein GA, Garfinkel BD, Borchardt CM. Comparative studies of pharmacotherapy for school refusal. J Am Acad Child Adolesc Psychiatry 1990; 29:773-781.
  • Bernstein GA, Borchardt CM. School refusal: family constellation and family functioning. J Anxiety Disord 1996; 10: 1-19.
  • Woodruff BJ, Morrow C, Bourland S, Cambron S. The behavior of anxious parents: examining mechanisms of transmission of anxiety from parent to child. J Clin Child Adolesc Psychol 2002; 31:364-374.
  • Whaley SE, Pinto A, Sigman M. Characterizing interactions between anxious mothers and their children. J Consult Clin Psychol 1999; 67:826-836.
  • Muris P, Steerneman P, Merckelbach H, Meesters C. The role of parental fearfulnes and modelling in children fear. Behav Res Ther 1996; 34:266-258.
  • Berg I, Jackson A. Teenage school refusers grow up: a follow up study of 168 subjects, ten years on average after in-patient treatment. Br J Psychiatry 1985;
  • Bernstein GA, Borchardt CM, Perwien AR, Crosby RD, Kushner MG, Thuras PD et al. Imipramine plus cognitive-behavioral therapy in the treatment of school refusal. J Am Acad Child Adolesc Psychiatry 2000; 39:276-283.
  • Flakierska N, Lindstrom N, Gillberg C. School refusal: a 15-20-year follow-up study of 35 Swedish urban children. Br J Psychiatry 1988; 152:834-837.
  • Flakierska PN, Lindstrom M, Gillberg C. School phobia with separation anxiety disorder: a comparative 20- to 29-year follow-up study of 35 school refusers. Compr Psychiatry 1997; 38:17-22.
  • Valles E, Oddy M. The influence of a return to school on the long-term adjustment of school refusers. J Adolesc 1984; 7:35-44.
  • Atkinson L, Quarrington B. School refusal: The heterogeneity of a concept. Am J Orthopsychiatry 1985; 55:83-101.
  • King N, Tonge B, Heyne D, Ollendick TH. Research on the cognitive-behavioral treatment of school refusal: a review and recommendations. Clin Psychol Rev 2000; 20:495-507.
  • Işık E, Taner YI. Çocuk, Ergen ve Erişkinlerde Anksiyete Bozuklukları. İstanbul, Golden Print, 2006.
  • Blagg NR, Yule W. The behavioural treatment of school refusal: a comparative study. Behav Res Ther 1998; 22:119-127.
  • Last CG, Hansen C, Franco N. Cognitive-behavioral treatment of school phobia. J Am Acad Child Adolesc Psychiatry 1998; 37:404-411.
  • King NJ, Tonge BJ, Heyne D, Pritchard M, Rollings S, Young D et al. Cognitive- behavioral treatment of school-refusing children: a controlled evaluation. J Am Acad Child Adolesc Psychiatry 1998; 37:395-403.
  • Clarke G, Rohde P, Lewinsohn P, Hops H, Seeley JR. Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions. J Am Acad Child Adolesc Psychiatry 1999; 38:272-279.
  • Labellarte MJ, Ginsburg GS, Walkup JT, Riddle MA. The treatment of anxiety disorders in children and adolescents. Biol Psychiatry 1999; 46:1567-1578.
  • King NJ, Tonge B, Heyne D. School refusal. In Phobic and Anxiety Disorders in Children and Adolescents: A Clinician’s Guide to Effective Psychosocial and Pharmacological Interventions (Eds TH Ollendick, J March): 236-271. New York, Oxford University Press, 2004.
  • Gittelman-Klein R, Klein DF. Controlled imipramine treatment of school phobia. Arch Gen Psychiatry 1971; 25:204-207.
  • Berney T, Kolvin I, Bhate SR, Garside RF, Jeans J, Kay B et al. School phobia: a therapeutic trial with clomipramine and short-term outcome. Br J Psychiatry 1981; 138:110-118.
  • Layne AE, Bernstein GA, Egan EA, Kushner MG. Predictors of treatment response in anxious-depressed adolescents with school refusal. J Am Acad Child Adolesc Psychiatry 2003; 42:319-326.
  • Velosa JF, Riddle MA. Pharmacologic treatment of anxiety disorders in children and adolescents. Child Adolesc Psychiatr Clin N Am 2000; 9:119-133.
  • Birmaher B, Axelson DA, Monk K, Kalas C, Clark DB, Ehmann M et al. Fluoxetine for the treatment of childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 2003; 42:415-423.
  • Clark DB, Birmaher B, Axelson D, Monk K, Kalas C, Ehmann M et al. Fluoxetine for the treatment of childhood anxiety disorders: open-label, long term extension to a controlled trial. J Am Acad Child Adolesc Psychiatry 2005; 44:1263-1270.
  • Riddle MA, Bernstein GA, Cook EH, Leonard HL, March JS, Swanson JM. Anxiolytics, adrenergic agents, and naltrexone. J Am Acad Child Adolesc Psychiatry 1999; 38:546- 556.
  • Simeon JG. Use of anxiolytics in children. Encephale 1993; 19:71-74.
  • Pfeffer CR, Jiang H, Domeshek LJ. Buspirone treatment of psychiatrically hospitalised pre-pubertal children with symptoms of anxiety and moderately severe aggression. J Child Adolesc Psychopharmacol 1997; 7:145-155.
  • Cobham VE, Dadds MR, Spence SH. The role of parental anxiety in the treatment of childhood anxiety. J Consult Clin Psychol 2002; 66:893-905.
Toplam 106 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Derleme
Yazarlar

Kayhan Bahalı Bu kişi benim

Ayşegül Yolga Tahiroğlu Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 2 Sayı: 3

Kaynak Göster

AMA Bahalı K, Tahiroğlu AY. Okul Reddi: Klinik Özellikler, Tanı ve Tedavi. Psikiyatride Güncel Yaklaşımlar. Eylül 2010;2(3):362-383.

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