What we can learn from the resignation syndrome endemic in Sweden
Permanent residence permits were used to treat resignation syndrome.
Resignation syndrome left previously healthy children unresponsive and dependent on full-time care for extended periods. A recent paper suggests that the strong commitment to protect the children impacted how symptoms were interpreted and the care that children received. And even contributed to shaping the condition itself.
The outbreak of resignation syndrome coincided with a period when medical assessments, child welfare practices, and migration decisions became increasingly intertwined in Sweden. Trauma and the threat of deportation faced by children and their families were seen as the cause, and permanent residence permits became the treatment.
The syndrome only affected a very specific group: children from former Soviet and Yugoslav states seeking asylum in Sweden. An article recently published in Philosophy, Ethics, and Humanities in Medicine, suggests that Sweden’s strong commitment to protecting vulnerable children may have influenced how the condition was understood and treated, with institutional responses becoming closely linked to the illness itself.
In the article, Karl Sallin, child neurologist at Astrid Lindgren Children’s Hospital and PhD student at Uppsala University’s Centre for Research Ethics & Bioethics, suggests that resignation syndrome may be a culture-bound illness, shaped not only by personal suffering, but also by Sweden’s social, political, and institutional systems.
Karl Sallin argues that Sweden’s strong focus on protecting vulnerable children may have influenced how the illness was diagnosed and treated. Alongside the children’s suffering, medical explanations, welfare policies, and migration policy became closely entangled with the condition, influencing how symptoms were understood and how they evolved over time. The political context as well as the narrative pushed by media outlets also contributed. Research on resignation syndrome has shown that when healthcare, social services, and migration authorities overlap, the systems meant to help can sometimes make illness last longer.
“Systems designed for safety can, under certain conditions, reinforce patterns of illness. The ambition was to protect these children,” Karl Sallin says.
“But when faced with a puzzling phenomenon, management was not always based on evidence and the response might have increased and prolonged the suffering of these children instead of easing it.”
The findings highlight the need for careful, interdisciplinary deliberation when health issues arise at the intersection of medicine, politics, and social policy.
The case of resignation syndrome shows that illness does not exist only inside the body. It also grows in the social and political systems around us, and around those affected. “In Sweden everyone wanted to do the right thing and protect the vulnerable, but when healthcare, welfare, and migration decisions became too closely connected, the response shaped how the illness unfolded – and when the connections were broken, the endemic waned. This reminds us how important it is to reflect carefully on how systems, institutions, and good intentions can influence illness,” says Karl Sallin.
By Anna Holm Bodin
Sallin, K. Looking back at resignation syndrome: the rise and fall of a culture-bound endemic. Philos Ethics Humanit Med 20, 41 (2025). DOI: 10.1186/s13010-025-00209-8