정신병리를 가진 청소년의 등교거부 사례보고

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(氣鬱化火,) 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.