The application of DSM-III diagnostic criteria to school refusal.

The DSM-III diagnostic criteria were applied to school refusal cases, and the possibility of a subclassification of school refusal through the DSM-III was studied. The subjects were 50 cases diagnosed as school refusal following the criteria defined by Sumi and Tatara. As for the Axis I diagnoses, the subjects fell under the separation anxiety disorder (7 cases), avoidance disorder (13 cases), overanxious disorder (8 cases), identity disorder (5 cases), adjustment disorder (11 cases) and others. On Axis II, no case was diagnosed as having the personality disorder, but 14 cases showed pathological personality traits. On Axis III, nine cases showed some physical disorders or conditions. Among the five major diagnostic groups, there were some definite differences concerning the onset age, clinical course, psychosocial stress, response to therapy and prognosis of disorders. These results suggest the availability of a subclassification of school refusal by means of the DSM-III criteria.