EPA-0905 - “I am hoarse! - a bullying clinical case”

Abstract

Introduction:Bullying can occur in several circumstances but nowadays it is largely widespread in schools. Several studies reveal the amount of psychopathology and behavioral changes that it determines, with special focus on children that can suffer silently or react with somatic disorders.Objectives:The authors present a clinical case of a girl who was victim of bullying, with the aim to describe the potential impact of bullying, as well as its clinical and social implications.Methods:Report and analysis of the clinical case of a 13 years old girl who was admitted as an outpatient at the Department of Child and Adolescent Psychiatry after being referred by her General Practitioner for having become hoarse abruptly. She has been followed in consultation, medicated with antidepressants and submitted to psychotherapy. We also performed a medical screening, particularly the otorhinolaryngology specialty, which failed to detect alterations that could justify the aphonia.Results:During the clinical appointments we identified some bullying episodes at school, whose worsening temporally matched with the moment when she became hoarse. After six months of follow-up and intervention, there was an improvement of the mood state; however she only regained her voice after an apology from the bully.Conclusions:Although some would argue that bullying can teach life lessons and give strength, there is a consensus that it represents a way of abuse. We should pay particular attention in children, since as in this case, they often react with somatic symptoms that can delay and misled the diagnostic and intervention.