Resignation syndrome (also called traumatic withdrawal syndrome or traumatic refusal or abandonment syndrome; ) is a catatonic condition that induces a state of reduced consciousness, first described in Sweden in the 1990s. The condition affects predominately psychologically traumatized children and adolescents in the midst of a strenuous and lengthy migration process. Young people reportedly develop depressive symptoms, become socially withdrawn, and become motionless and speechless as a reaction to stress and hopelessness. In the worst cases, children reject any food or drink and have to be fed by feeding tube; the condition can persist for years. Recovery ensues within months to years and is claimed to be dependent on the restoration of hope to the family. Signs and symptoms Affected individuals (predominantly children and adolescents) first exhibit symptoms of anxiety and depression (in particular apathy, lethargy), then withdraw from others and care for themselves. Eventually their condition might progress to stupor, i.e. they stop walking, eating, talking, and grow incontinent. In this stage patients are seemingly unconscious and tube feeding is life-sustaining. The condition could persist for months or even years. Remission happens after life circumstances improve and ensues with gradual return to what appears to be normal function. Nosology Resignation syndrome (RS) and pervasive refusal syndrome share common features and etiologic factors; however, the former is more clearly associated with trauma and adverse life circumstances. Neither is included in the standard psychiatric classification systems. Pervasive refusal syndrome (also called pervasive arousal-withdrawal syndrome) has been conceptualised in a variety of ways, including a form of post-traumatic stress disorder, learned helplessness, ‘lethal mothering’, loss of the internal parent, apathy or the ‘giving-up’ syndrome, depressive devitalisation, primitive ‘freeze’, severe loss of activities of daily living and ‘manipulative’ illness, such as parents drugging children for increased chance of being granted asylum. It was also suggested to be on the 'refusal-withdrawal-regression spectrum'. Acknowledging its social importance and relevance, the Swedish National Board of Health and Welfare recognized the novel diagnostic entity resignation syndrome in 2014. Others, however, argue that already-existing diagnostic entities should be used and are sufficient in the majority of cases, i.e. severe major depressive disorder with psychotic symptoms or catatonia, or conversion/dissociation disorder. Currently, diagnostic criteria are undetermined, pathogenesis is uncertain, and effective treatment is lacking. Causes Resignation syndrome appears to be a very specialized response to the trauma of refugee limbo, in which families, many of whom have escaped dangerous