School phobia is a massive anguish that occurs at the mere thought of going to school. It typically manifests itself upon leaving home by a panic attack which only fades when the child is convinced that he will not go to school.

In 2011, it was defined in the Official Journal: “ School phobia, or anxious school refusal, is a manifestation of refusal to attend school, to be distinguished from refusal to learn or learning difficulties.

La French Classification of Mental Disorders of Children and Adolescents R- 2012 retains the following definition: “manifestation of major anxiety with often a phenomenon of panic linked to school attendance and prohibiting its continuation in the usual forms”.

The phenomenon of school phobia has been studied since the 1882th century, obviously after the establishment of compulsory school in 1887. As early as 1911, Alfred Binet mentions a child who, because of fear of school, plunges into real silence in the classroom. In 11, Jung recounts an episode of “neurotic refusal” to go to school observed in an XNUMX-year-old girl, whom he describes as suffering from an Oedipus complex on a teacher.

It was in 1941, however, that the term school phobia was defined by AM Johnson as a ” intense terror associated with being in school “. For Johnson, this inability to get to school is independent of their will. In France, Ajuriaguerra brings a definition which will remain a reference when he describes children suffering from school phobia as “children who for irrational reasons refuse to go to school and resist with very strong reactions of anxiety or anxiety. panic when you try to force them to do so ”. 

The term “school phobia” has been called into question several times insofar as it does not correspond to the classic descriptions of phobias: the object which leads to the phobia is not clearly identified (school, teachers, students, to leave his parents or his home…).

For this reason, the term “school refusal” has been retained in the international literature.

School phobia constitutes about 5% of the reasons for consultation in child psychiatry and would touch between 1 and 2% of children of school age.

It can appear at any age but two age categories are more conducive to its appearance: entry to preparatory course, around 6 years old, and adolescence, from entry into 6^st around 11 years old when entering 4^st around the age of 13-14 years. These age categories are marked by stages of somatopsychic maturation, such as the capacity for hypothetico-deductive reasoning.

In 1972, Hersov classed “school refusal” as the 4^st cause of school absenteeism after the illness, the child retained by his parents at home and truant, with which it is necessary to mark a profound difference.

Studies show that girls are affected as much as boys, although it seems that boys are a little earlier.

It seems that intelligent, serious students, whose investment is significant, are more at risk. 

According to some authors, the school phobia occurring in early childhood is mainly linked to separation anxiety.

In adolescence, it would be specific to a period of maturation difficult to bear for the adolescent as for the family.

There are some associated risks such as sleep disturbances, depression, low self-esteem and risk of suicide. 

The main symptoms of a school phobia are easily recognizable:

– Difficulties leaving home to go to school.

– Complete school absenteeism.

– Vivid emotional reaction marked by anxiety and panic.

– Absence of antisocial behavior (the child continues his outdoor activities).

– The child does not hide his situation from his parents.

– The child refuses to go to school without reason.

In theory, the child is marked by the inability to leave home and is only relieved when he is sure that he will not go to school the same day. Usually he promises he will go the next day, but the scene repeats. In adolescents, the situation is comparable: the parents are in the know, while he wanders until reality catches up with him.

The occurrence of “phobia” is often brutal, from the start of the school year, on return from vacation or following a particular event.

It is important not to confuse school phobia with other disorders whose symptoms may suggest:

• THEskipping school, which is distinguished by its hidden character. The child avoids school without the knowledge of his parents and generally hangs out with other children, running the significant risk of deviant behavior.
• Le refusal of school acquisition, which focuses primarily on dropping out of school. The child continues to go to school but does not retain the desire to learn and the results are felt. It is not anxiety that is predominant but on the contrary the latent and inexorable gloom.
• La video game addiction can sometimes resemble school phobia. It will be necessary to detect a maximum presence with the computer and an almost passionate infatuation with a parallel world that can leave traces (sleep disorders, lags, antisocial behavior).

In adolescence, the return to class is measured between 40 and 60%. Strangely enough, being female, being over 16 or being the last of a sibling are factors inhibiting healing.

Early treatment improves the course of the disorder.

According to the authors, we describe a distribution in thirds of the different cases:

• A third progress to a frank psychiatric disorder such as anxiety disorders, depression or a personality disorder.
• A third are recovering very favorably.
• A third is recovering but still have social or professional integration difficulties. The risks of social marginalization and delinquency are increased.

The treatment is complex, difficult and often disappointing. It is based on a individual psychotherapy and family care.

Significant change is capital in the healing process: it can be a change of school environment, a move, hospitalization or a profound questioning of the family balance. Institutional management may be considered after 6 months of failure of outpatient treatment.