Bullying a review: Presentations to an adolescent psychiatric service and within a school for emotionally and behaviourally disturbed children

This 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.