Prevalence of School Refusal And Separation Anxiety

School refusal is usually estimated to occur in 0.4% to 1.5% of the general population. Interestingly, however, some reports suggest that as many as 69% of referrals for any kind of child phobia are for School refusal, and the problem is seen in approximately 3% to 8% of clinic-referred children. Miler and others have suggested that this may be due to the fact that the problem creates considerable difficulty for parents and school personnel.
The prevalence of separation anxiety disorder is uncertain, but it is described in DSM-IV as not uncommon and it is probably one of the most common anxiety disorders in children with an estimated prevalence of about 4%. The prevalence declines after early childhood and the disorder is probably uncommon in adolescent.

School refusal, in the other hand, can be found in children of all ages. There is the suggestion that in youngster children the problem is likely to be related to separation anxiety, but children in middle age groups and early adolescence are likely to have complex and mixed presentations of anxiety and depressive disorders. Prognosis seems best for children under the age of ten years and successful treatment seems to be particularly difficult with older children. If left untreated, serious long term consequences seem possible. In older adolescents separation anxiety may be the precursor of more serious problems. As adults such individuals may be at risk for a number of problems. Large scale longitudinal studies are clearly needed to clarify hypothesized relationships to adult disorders such as agoraphobia and panic disorder.

Behavior Disorders of Childhood by Rita Wicks-Nelson & Allen C. Israel

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