Post traumatic withdrawal state in children seeking asylum: a case report and analysis of existing literature

Abstract

Refugee and asylum-seeking and children experience wide range of difficulties during the migration process. A number of non-organic syndromes (Resignation Syndrome, Pervasive Refusal Syndrome and Depressive Devitalisation) presenting with potentially life-threatening refusal in eating, drinking, speech, mobilisation, and personal care accompanied with social withdrawal and apathy have been reported in this population following witnessing or experiencing a traumatic event. The majority of cases have been reported in Sweden. We present a case from the UK. Our patient, a Middle Eastern adolescent boy, went into a state of withdrawal after witnessing a fatal beating in 2018. We have offered robust social care in addition to medical and psychological interventions. We analyse the literature to understand the complex interplay of moderating and mediating factors in the socio-political context of this population and how this affects the management. In our opinion, this group of rare but debilitating and neglected syndromes should be recognised and treated, given the severity of symptoms.