Ibeziako Patricia, Choi Christine, Randall Edin, Bujoreanu Simona
Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
Department of Psychiatry, Boston Children's Hospital, Boston, Massachusetts; and.
Hosp Pediatr. 2016 May;6(5):290-6. doi: 10.1542/hpeds.2015-0207. Epub 2016 Jan 1.
The purpose of this study is to describe the prevalence of bullying victimization among medically admitted patients with somatic symptom and related disorders (SSDs) and to compare demographic, diagnostic, and psychosocial characteristics of bullied versus nonbullied patients.
Medically admitted patients at a tertiary pediatric facility referred to the Psychiatry Consultation Service with somatic concerns were assessed via a quality improvement (QI) initiative, the SSD Standardized Clinical Assessment and Management Plan (SSD-SCAMP). Retrospective chart and QI data on adolescent and young adult patients assessed via SSD-SCAMP from May 2012 - December 2014 were reviewed.
Medical records of 282 patients (aged 12-22 years) diagnosed with SSDs were reviewed. Approximately 37% had a history of bullying victimization. Compared with nonbullied patients, bullied patients had higher somatization scores, more functional neurologic symptoms, and longer admissions. Bullied patients also had higher rates of comorbid anxiety, suicidal histories, and family psychiatric histories. Furthermore, bullied patients also had higher rates of learning disabilities and school accommodations and endorsed more significant life events within the year before hospitalization.
This study describes the unique health and psychosocial challenges experienced by medically hospitalized bullied adolescents and young adults with SSDs. The findings highlight the importance of a multidisciplinary approach to assessment and management. By implementing QI initiatives such as the SSD-SCAMP, providers can bridge the gap between the clinical needs and long-term management of patients with SSDs.
本研究旨在描述因躯体症状及相关障碍（SSD）而入院治疗的患者中受欺凌受害情况的患病率，并比较受欺凌患者与未受欺凌患者的人口统计学、诊断及心理社会特征。
通过一项质量改进（QI）举措，即SSD标准化临床评估与管理计划（SSD-SCAMP），对一家三级儿科机构中因躯体问题转诊至精神科会诊服务的入院患者进行评估。回顾了2012年5月至2014年12月期间通过SSD-SCAMP评估的青少年及青年成年患者的回顾性病历和QI数据。
对282例诊断为SSD的患者（年龄在12 - 22岁之间）的病历进行了审查。约37%的患者有受欺凌受害史。与未受欺凌的患者相比，受欺凌患者的躯体化得分更高、功能性神经症状更多且住院时间更长。受欺凌患者的共病焦虑、自杀史及家族精神病史的发生率也更高。此外，受欺凌患者的学习障碍和学校适应性问题发生率更高，并且在住院前一年认可有更重大的生活事件。
本研究描述了因SSD而住院治疗的受欺凌青少年及青年成年患者所面临的独特健康和心理社会挑战。研究结果凸显了多学科评估与管理方法的重要性。通过实施诸如SSD-SCAMP等QI举措，医疗服务提供者可以弥合SSD患者临床需求与长期管理之间的差距。
