Pervasive Refusal Syndrome in Autistic Spectrum Disorder

Pervasive Refusal Syndrome (PRS) is a rare child psychiatric condition. We describe a case of PRS in a 9-year-old boy with adiagnosis of Autism Spectrum Disorder (ASD) presenting with severe weight loss due to extreme restriction of food and fluids.Other prominent symptoms included total mutism, school refusal, and self-neglect. He was admitted to a specialist Child andAdolescent Mental Health Unit. We discuss the symptoms present in this case and the differential diagnosis of ASD in PRS. Althoughthis differential has briefly been considered one in previous case, there have been no reported cases of PRS with a prior diagnosisof ASD. We explore comorbidity and interaction of the two diagnoses. We discuss the possible impact of ASD as a predisposingfactor upon the progression and prognosis of PRS