A B S T R A C TThis article reviews the literature on bullying with particular reference to associated psychiatric symptoms and presents data and case examples from an inpatient and outpatient adolescent service and a school for emotionally and behaviourally disturbed children (EBD school). Bullying or its effects do not seem to be a distinguishing factor among those admitted to an adolescent unit. In the outpatient group, however, being bullied is frequently a factor in the presentation of adolescents to psychiatric services, with depression being the diagnosis in over 70% of cases. In contrast, bullies and bully/victims were most likely to present with conduct disorders, which were frequently co-morbid with hyperkinetic disorder/attention deficit hyperactivity disorder (ADHD). Unsurprisingly, regardless of whether bully, victim, bully/victim or neither, the most common psychiatric diagnosis of the EBD school pupils who were interviewed was that of conduct disorder. This was sometimes co-morbid with AD(H)D but also seen alongside generalized anxiety disorder and major depressive disorder.In an adolescent unit and in an EBD school, being bullied or a bully is an important factor associated with psychiatric symptomatology and should be regarded as a substantial mental and public health issue. K E Y W O R D S adolescent, bully, depression, health, victim
The research presented in this article suggests that young people attending schools for pupils with emotional and behavioural difficulties are more likely to experience concurrent psychiatric disorders (comorbidity) than their peers in mainstream schools. Dr Cassidy (Consultant in Child and Adolescent Psychiatry), Dr James (Consultant and Honorary Senior Lecturer in Child and Adolescent Psychiatry) and Dr Wiggs (Research Psychologist) used questionnaires and interviews with parents and teachers, together with pupil self‐reporting, to gather their data. The two‐stage investigation suggested that 89% of the adolescents in one school for pupils with EBD met established criteria for the diagnosis of a psychiatric disorder. Conduct disorder and attention deficit hyperactivity disorder (ADHD) emerged as the most common psychiatric difficulties, but emotional disorders were also prominent in the data. These untreated problems are likely to have significant long‐term implications for the psychological and educational development of the pupils concerned, and the authors speculate on some of the ways in which psychiatric and education services might work together in order to improve the outlook.
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