By Fagbohun AO (2023). Greener Journal of Medical Sciences, 13(1): 1-3.
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Vol. 13(1), pp. 1-3, 2023
ISSN: 2276-7797
Copyright ©2023, the copyright of this article is retained by the author(s)
DOI: https://doi.org/10.5281/zenodo.7674129
https://gjournals.org/GJMS
Department of Paediatrics, College of Medicine, University of Ibadan.
And University College Hospital, Ibadan, Oyo State, Nigeria.
Type: Research
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DOI: 10.5281/zenodo.7674129
Bullying has become an increasing public health problem globally; however, it is not frequently reported in developing countries such as Nigeria. A case of verbal bullying resulting in suicidal ideation and attempts is described in this report. The similarities between this case and reports in literature highlight the negative trend of bullying and attendant consequences. In literature the common means of attempted suicides in females is by ingestion of poison and toxins as was the case in this report. This case could be an indication that the burden of bullying and resultant consequences in Nigeria may be of a higher magnitude than envisaged as these experiences are rarely reported to a formal health facility.
Published: 24/02/2023
Dr Abieyuwa O. Fagbohun
E-mail: mailyuwa@ yahoo.com
INTRODUCTION
Bullying is defined as intentional and repeated acts that occur through physical, verbal, and relational forms in situations where a power difference is present.(1). Suicide attempt, on the other hand can be defined as a self-destructive act deliberately carried out where there is a clear expectation of death.(2). Bullying victimization has been identified as a risk factor for suicide ideation and attempts in adolescence.(3). A case of verbal bullying leading to attempted suicide in a female schooling adolescent is hereby reported.
CLINICAL OBSERVATION
F.O. is a 14-year-old female adolescent who was first seen at the Emergency Department of the University College Hospital, Ibadan after a one-day history of deliberate ingestion of Saponated cresol (a potent germicide) in a bid to commit suicide due to ongoing verbal bullying at school and frequent altercations with her mother at home. Prior to this, the patient had been experiencing melancholy, despondency, insomnia, and loss of appetite. She was ridiculed because of her naturally curly and thick hair and was constantly referred to as ‘Medusa’ (a creature in Greek mythology with snakes on her head instead of hair). Repeated attempts at obtaining parental consent to straighten her hair with chemical agents were denied. She said, ‘I was tired of the name-calling and wanted to end it all’. There was no history of chronic illness. There was a two-year prior history of suicide ideation, which was dismissed following a conversation with a close friend. This ideation was not disclosed to any family member or the school authorities. After ingestion of the substance, she was given palm oil by her parents which caused three episodes of vomiting and abdominal pain. She was thereafter rushed to the emergency room. Examination at presentation revealed a calm female adolescent who was conscious and alert. The only abnormality noted was the presence of suprapubic tenderness, all other systems were normal. Mental state examination by the adolescent psychiatrist was normal. Her abdominal ultrasound scan, full blood count, urinalysis, pregnancy test, electrolytes and urea did not reveal any abnormality. A diagnosis of deliberate self-harm was made. She was admitted for one night in the emergency room and discharged thereafter to be followed up at the adolescent paediatric clinic.
All clinic appointments were attended in the company of her mother with the adolescent paediatrician and public health nurse in attendance. Both mother and FO were counselled extensively. F.O. exhibited reluctance at reporting the bullying episodes to the school authorities as she believed it would further worsen the situation. There was no anti bullying policy in her school. Her mother eventually granted permission for the use of hair straightening agents. The relationship between patient and mother improved significantly, FO became more self-confident, and she was able to stand up to her bullies. The bullying eventually stopped. Her appetite and mood improved significantly with the sleep pattern becoming better. Her clinic attendance also continued.
DISCUSSION
In recent years, there has been a rise in global attention to bullying and its attendant consequences as a major public health concern.It has been shown to have negative short and long term consequences affecting the perpetrator, the victim and the observers(4). A meta-analysis conducted on schooling adolescents in low- and middle-income countries reported the prevalence of suicide attempts and bullying victimization as 10.7% and 30.4% respectively. This same study also reported a 32.7% prevalence of suicide attempts amongst bullied adolescents compared to 5.9% in those who were not bullied. (3). Suicidal ideation and attempts have been reported to be significantly associated with bullying in schooling Nigerian adolescents.(5)In Eastern Nigeria, it was reported that bullied adolescents had a 51.8% prevalence of suicidal ideation(6).
In literature, the various means of attempted suicide are hanging, ingestion of poisons, drowning and the use of firearms.(7) Males tend to use more violent methods when attempting suicide such as hanging/gunshots unlike their female counterparts who are more likely to use self-poisoning as was seen in the case reported(8).In Nigeria, the most reported poison deliberately ingested by adolescents during suicidal attempts is organophosphate(9)However, Saponated Cresol was the poison of choice in this case. Acute cresol poisoning has been shown to affect various systems of the body such as respiratory, haematological, gastrointestinal, renal, neurological and cardiovascular(10). The patient however did not present with any clinical or laboratory signs of poisoning. This could be explained by the fact that the cresol was diluted with approximately 200mls of water prior to ingestion thus minimising the toxic effects of the compound.
CONCLUSION
This case brings to the fore that bullying is a common occurrence amongst secondary school students and can lead to suicidal ideation and attempts. Forestalling this trend requires the institution ofanti-bullying laws and policies in all learning centres in the country. It also highlights the fact that in regular practise, paediatricians must have a heightened index of suspicion for the dangers of bullying and address them appropriately.
REFERENCES
[5] Adeosun I, Ogun O, Adegbohun A, et al. EPA-0891 – Violence victimization and suicidal behavior among secondary students in nigeria. European Psychiatry 2014;29:1.
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