School Refusal with Anxiety: a Review of Sixty-Three Cases *

Abstract

A review of 63 cases of school refusal with anxiety seen at the Maudsley Hospital, London, England, indicates that the disorder has the following features:

1) peak incidence at age 11 or 12,

2) higher proportion of youngest children in the family,

3) presence of three separate syndromes seems indicated (with some intermixtures), namely,

a) separation anxiety in the younger patients and in those whose difficulties started at a young age,

b) school phobia in the older patients without previous episodes, and

c) depression or withdrawal in some adolescents,

4) excellent prognosis as far as return to school is concerned, although somewhat poorer for patients of age 13 or over.