Identification and prevalence of factors associated with the outcome of psychiatric treatment of youths who refuse to attend school

Objectives To assess the prevalence and investigate factors associated with resumption of school attendance by youths who have previously refused to go to school. Methods Between 2012-2018, a retrospective cross-sectional study measured the baseline situation and outcomes after 3 months of treatment at one tertiary child and adolescent psychiatric service of youths who refused to attend school. Sociodemographic, clinical and family characteristics as well as school environment characteristics and child behavior were used to identify possible correlations with short-term outcomes of youths who had refused to attend school. Results A total of 111 patients age 5-18 displayed a refusal to attend school. Of those, 71 patients who could be followed up for at least 3 months were examined. Of those 71 patients, 22 (31%) resumed regular school attendance and 21 patients (29.6%) resumed attending school occasionally. All subjects had been diagnosed with a psychiatric disorder at baseline, and 32.4% had been diagnosed with at least two psychiatric disorders. Multiple logistic regression revealed that younger age below 14.58 years (p = 0.003), having siblings (p = 0.014), living with biological parents (p = 0.018) and having had negative interactions with teachers or learning (p = 0.029) correlated with favorable outcomes. Conclusions Youth who refuse to attend school have a high incidence of psychiatric disorders. Short-term outcomes of psychiatric treatment are fair. Outcomes of treatment of psychiatric disorders are associated with four factors: age, having siblings, living with biological parents, and having had negative interactions with teachers or learning. However, other outcomes eg., emotional/behavioral symptoms, self-efficacy, social adjustment, well-being of the patient/family and global assessment of functioning should also be considered.