The drama of the war, the uprootingand forced migration from their country of origin under conditions of very high risk, joined to failure to insert in a new context, it represents a traumatic event very powerful. It so happens that some children and teenagers like unique response possible to so much suffering, they fall into a Deep sleep from which it seems impossible to awaken them. This is the case with the little one Samir, escaped from the bombs in Syria, or Syrian refugee children in Sweden without a residence permit. How to deal with this situation? We talk about it with , psychotherapist of the developmental age at the Bambino Gesù Pediatric Hospital in the city.
In this article
- Resignation syndrome: the origin of the phenomenon
- WHO guidelines
- Resignation and post-Covid syndrome
- Characteristics of a "resigned" child
- Similarities with the catatonic child
- Treatment available for resignation syndrome
Resignation syndrome: the origin of the phenomenon
Is the resignation syndrome a recent phenomenon or have there been cases in the past as well?
"It is a recently identified disorder. It has been given a name in early 2000s precisely in reference to the experiences of colleagues swedes who noticed the symptoms in the children of refugees from the the former Yugoslavia. However, going back in time, it is possible to find very similar cases: in concentration camps boys and young adults in prison fell asleep without waking up again. They have never been scientifically verified, but they probably are assimilable to this syndrome. Again, in the United States, In years' 80, symptoms attributable to the resignation syndrome were found in the adolescent population of refugees and children of refugees. Scientific codification, however, came much later ".Read also: A life without a home. Images from refugee camps in Syria
Are there any WHO guidelines on this syndrome?
"There are no guidelines. In 2022 some emerged proposals e recommendations which, however, do not refer to standard therapeutic procedures. There has been talk of the desirability of give citizenship, with an official welcome, to these children and their families. A measure absolutely recommended and useful but in and of itself not sufficient".
Resignation and post-Covid syndrome
Can a similar condition also occur in post-Covid?
"We have never encountered such a serious condition. What we are observing, however, are reactions that certainly they are coming closer to the syndrome of resignation: extreme isolation, total apathy, lack of initiative, the failure of all those daily activities related to care andpersonal hygiene, the lack of emotional response to external stimuli. The Covid it has altered normality, habits and everyday life, so it can certainly represent a trauma ".Read also: Covid-19: how to restore confidence and hope to children?
Characteristics of a "resigned" child
What are the characteristics of a "resigned child"?
"A child with resignation syndrome has symptoms much more serious than those post Covid. In fact, it falls into a state of numbness, with a total inability to respond to any stimulus. These babies need to be fed a tube. They do not voluntarily avoid the stimulus, as can happen in post-Covid: there is an absolute absence the ability to respond to any stimulus. In common there is the rejection of suffering and the consequent withdrawal from the world. Here, however, a deep sleep, given by a suffering just as deep channeled at the body level. Samir had clear and vivid images before him of himself and his family fleeing the bombs in Syria. A condition of extreme fear, unattainable, which he has transferred into his own body. After that, the trauma of escape follows another trauma: That of the I decline, the failure to insert in the new country ".
Similarities with the catatonic child
Are there any similarities with a catatonic baby?
"The clinical picture is very similar. There is, however, an important difference: the catatonia it's a psychiatric disorder which often has genetic basis and implies dysfunctions from the postural neurological. Instead the resignation syndrome falls between reactive conditions: it is a reaction to an external factor. It is not a disease that exists in itself, but one response to traumatic factors, triggered by environmental events ".Read also: Depression: when it affects children and adolescents
Treatment available for resignation syndrome
What treatments do we have available?
"We must act with a integrated approach. As I said before, the inclusion and conferral of citizenship are important, but they are not enough. In fact, we are talking about one medical condition that involves different floors: neurological, psychiatric, psychological, social. These kids go through one full evaluation to check the level of cognitive and emotional development, also passing through medical analysis aimed at excluding causes related to other factors. Based on this evaluation we try to intervene with non-pharmacological approaches, which can only be accessed in the most serious cases. It provides a individual and family support, which also extends to the social sphere and the insertion we talked about initially. Just an approach that operates on multiple levels allows us to overcome this serious condition ".
is a psychologist and developmental psychotherapist at the Department of Child and Adolescent Neuropsychiatry of theBambino Gesù Children's Hospital of the city.
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