Resignation syndrome in children

Daria is seven years old, Ukrainian and lives in Sweden. She does not react when spoken to or touched. She is fed through a nasogastric tube. Her story and that of other minors star life surpasses medocumentary produced by Netflix.

Daria presents a strange neuropsychiatric condition known as «resignation syndrome. Since the 1990s, cases of children with this syndrome have been recorded in Sweden, children of refugees from the former Yugoslav and Soviet republics.

This syndrome has a progressive onset, children begin to withdraw, lose their appetite and not go to school, entering a state of stupor. –a state of partial unconsciousness, close to the appearance of coma-, which results in a catatonic and unconscious state, which can last months or even years.

What is resignation syndrome?

It is called resignation syndrome. a strange alteration that has been occurring in Sweden for decades in the refugee child and adolescent population. In 1958, Swedish psychiatrist Anna-Lisa Annel described this syndrome as a very rare disorder that occurred mainly after severe psychological trauma.

It was not until 1998 when Sweden recorded the first case of this syndrome, describing it as a long-term disorder that affects psychologically traumatized children and adolescents who are immersed in a migratory process.

In 2014, the Swedish National Board of Health and Welfare included the diagnosis of resignation syndrome as a separate diagnostic entity. Children and adolescents who are victims of this syndrome are popularly known in Sweden as apathetic children. (apatiska barn).

How does it manifest and why?

This is characterized by a depressive onset that progresses with the appearance of an extreme level of apathy, immobility and mutism for no apparent biological reason. Observing, first of all, a decrease in usual behavioral patterns, daily activities and motivation. These children subsequently enter a catatonic state, similar to a coma, for months or years, remaining still and inert.

According to Elisabeth Hultcrantz, a volunteer doctor, the trigger for the cases described arises when immigrants are informed that they are denied asylum and find that they must return to the country of origin, and the main cause of this syndrome may be trauma in brain.

Other experts also agree point out traumatic experiences as a precondition to develop this syndrome, usually the threat of deportation to the country of origin.

Recent research on resignation syndrome:

Hultcrantz and Knorring conducted research in 2019 with 46 children with resignation syndrome, and highlighted that all asylum-seeking children, who developed resignation syndrome in Sweden, were exposed to trauma, persecution and violence.

Apart from influencing a difficult and traumatic living condition in the family, an individual vulnerability is also present, since in this study not all minors in the same family had been affected by the syndrome. Additionally, most of the children had a history of mental illness, depressive disorder, and post-traumatic stress disorder.

Other common characteristics in the minors was that the majority of the children belonged to repressed and persecuted ethnic minorities, such as the areas of the Balkans, the former Soviet Union, Yugoslavia or Syria.

The average age at which the first symptoms appeared was 11 years. and, in most cases, children entered this state after their families were informed of an upcoming deportation.

The minor who experienced this syndrome was usually the one who had been responsible for his familyacting as translator, or the one who had lived the most traumatic experiences in the country of origin, such as violence and murder of one or more members of their family, or they themselves had been the victims

Resignation syndrome usually appears at age 11 and is normally related to traumatic experiences.

Has it only been observed in Sweden?

Few cases of children and adolescents with the same or similar symptoms have been recorded in other countries. In Australiaa very similar syndrome has been observed in refugee and asylum-seeking children who had been on the island of Nauru.

Apart from being related to previous traumas and threats of deportation, the exact causes of this syndrome are not known nor the reason for reporting it only in this country, but there is also talk of the influence of a social and cultural factor of the disease (culture-bound).

A known case of minors affected by resignation syndrome in the same family is that of the Djeneta sisters and Ibadetarefugees from Kosovo, whose image was awarded by the World Press Photo photojournalism contest in 2018. Djeneta had been bedridden for 2 and a half years without responding and her sister Ibadeta for more than six months.

After the great unknowns surrounding resignation syndrome in children, more research is necessary so that children like Daria, Karen or Leyla can have more specific and precise treatment.

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