Journal of Oriental Neuropsychiatry (동의신경정신과학회지)

The Korean Society of Oriental Neuropsychiatry (대한한방신경정신과학회)
권호 표지

A Research of School Refusal on Adolescent with Psychiatric Disorders

정신병리를 가진 청소년의 등교거부 사례보고

  • Heo, Eun-Jung (Dept. of Oriental Neuropsychiatry, Chun-Cheon Oriental Medical Hospital) ;
  • Lee, Sang-Eon (Dept. of Neuropsychiatry, College of Oriental Medicine, Won-Kwang University) ;
  • Lyu, Heui-Yeong (Dept. of Oriental Neuropsychiatry, Chun-Cheon Oriental Medical Hospital)
  • 허은정 (춘천한방병원 한방신경정신과) ;
  • 이상언 (원광대학교 한의과대학 한방신경정신과 교실) ;
  • 류희영 (춘천한방병원 한방신경정신과)
  • Received : 2010.10.28
  • Accepted : 2010.12.06
  • Published : 2010.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.

Keywords

References

  1. 교육과학기술부. 교육통계연보(2009). 서울: 교육과학기술부. 2009:367-80.
  2. 강원섭, 반건호. School refusal : behavioral or psychopathologic?. 대한의사협회지. 2005;21(1):20-30.
  3. Broadwin IT. A contribution to the study of truancy. J Am Orthopsychiatry. 1932;2:253-9.
  4. Hersov L. Persistentnon-attendance at school. J Child Psychol Psychiat. 1960;1:130-6. https://doi.org/10.1111/j.1469-7610.1960.tb01987.x
  5. Atkinson L, Quarrington B, Cyr JJ. School refusal : the heterogeneity of a concept. J Am Orthopsychiatry. 1985;55:83-101.
  6. Berg I. School avoidance, school phobia, and truancy. In:Child and adolescent psychiatry. 2th ed. Baltimore:Williams & Wilins. 1996:1104-10.
  7. Berg I, Nichols K, Pitchard C. School phobia-its classification and relationship to dependency. J Child Psychopsychiatry. 1969;10:123-41. https://doi.org/10.1111/j.1469-7610.1969.tb02074.x
  8. Egger HL, Costello EJ, Angold A. School refusal and psychiatric disorders : a communicative study. J Am Acad Child Adolesc Psychiatry. 2003;42:797-807. https://doi.org/10.1097/01.CHI.0000046865.56865.79
  9. Bernstein GA, Hektner JM, Borchardt CM, McMillan MH. Treatment of school refusal : one-year follow-up. J Am Acad Child Adolesc Psychiatry. 2001;40:206-13. https://doi.org/10.1097/00004583-200102000-00015
  10. Bernstein GA, Massie ED, Thuras PD, Perwien AR, Borchardt CM, Crosby RD. Somatic symptoms in anxious-depressed school refusers. J Am Acad Child Adolesc Psychiatry. 1997;36:661-8. https://doi.org/10.1097/00004583-199705000-00017
  11. Elliott JG. Practitioner review : school refusal : issues of conceptualization, assessment, and treatment. J Child Psychiatry. 1999;40:1001-12. https://doi.org/10.1111/1469-7610.00519
  12. Bernstein GA, Garfinkel BD, Borchardt CM. Comparative studies of pharmacotherapy for school refusal. J Am Acad Child Adolesc Psychiatry. 1990;29:773-81. https://doi.org/10.1097/00004583-199009000-00016
  13. King NJ, 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. https://doi.org/10.1097/00004583-200102000-00014
  14. Berg I. Absence from school and mental health. Br J Psychiatry. 1992;161:154-66. https://doi.org/10.1192/bjp.161.2.154
  15. 안동현, 유한익. 학생정신건강검진 : 학생건강검진 개선안보고서. 서울: 보건복지가족부. 2009.
  16. 안동현, 김윤영, 장혜진, 강화연. 2003년도 전국정신보건센터 아동청소년정신보건사업-연구조사. 서울: 한양대학교 정신건강연구소. 2003.
  17. Eisenberg L. School phobia : a study in the communication of anxiety. Am J Psychiatry. 1957;114:712-8.
  18. 전국한의과대학 신경정신과 교과서편찬위원회. 한의신경정신과학. 파주: 집문당. 2007:227-34, 256-60, 532-4.
  19. Mack JE. Self-esteem and its development. New york:international university press. 1983:1-42.
  20. Hiroshi Oosawa. SHOKUGENSEI SHOKOGUN. Tokyo:Brain Shuppan Co. 1986:24-7.