Pervasive refusal syndrome or anorexia nervosa: a case report with a successful behavioural treatment

Eat Weight Disord. 2021 Aug;26(6):2089-2093. doi: 10.1007/s40519-020-00991-8. Epub 2020 Aug 20.


Purpose: Pervasive refusal syndrome (PRS) is a rare psychiatric disease that affects children. It was first described by Lask in 1991 (Arch Dis Child 66:866-869, 1991). Recently, Otasowie and Collaborators reported a systematic review about PRS. Despite this, PRS has not yet been classified in DSM-5 and ICD-11 and the lack of evidence-based treatment makes this syndrome a real challenge for clinicians. The aim of this paper is to present our experience through the description of a case report and its treatment.

Methods and results: The case reported is a girl aged 11 years that fits the clinical picture described in the literature of PRS. In previous reports, behavioural treatment was not used or appreciated; our case adds new knowledge regarding the PRS diagnosis and the successful behavioural treatment during hospitalization, which we describe in all its phases.

Conclusion: PRS is a rare, life-threatening syndrome; it would be extremely important to have an official and evidence-based treatment guide.

Level of evidence: Level V, case report.

Keywords: Behavioural treatment; Case report; Children; Eating disorders; Feeding disorders; Pervasive refusal syndrome.

Publication types

  • Case Reports

MeSH terms

  • Anorexia Nervosa* / complications
  • Anorexia Nervosa* / therapy
  • Behavior Therapy
  • Child
  • Child Development Disorders, Pervasive*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Syndrome