[Mental disorders induced by experiences of being bullied]

The author investigated 25 adolescent patients (9 males, 16 females) whose mental disorders seemed to be induced by their experiences of being bullied at school. The patients were treated by the author in the outpatient clinic or the inpatient ward of National Defense Medical College Hospital during 10 years, 1978 through 1988. These patients were classified into 4 groups from the viewpoint of their clinical symptoms and signs. The author called each group as follows; 1) paranoid-hallucinatory group, 2) withdrawal group, 3) escaping-into-fantasy group, and 4) somatoform group. The paranoid-hallucinatory group had premorbid personality traits of shame and introversion. Because of this character, they couldn't make friends and became easily the targets of bully. They developed psychotic signs after many years of being bullied. The contents of their hallucinations and delusions are closely related with their experiences of being bullied. Their integration of personality is maintained for long in spite of the severe psychotic symptoms and signs. The withdrawal group had similar personality tendency as that in the first group. They withdrew from social relationships and confined themselves to their rooms. But they kept desire for social relations and had more realistic and more fruitful thought than the first group had. Most of them returned to the normal social life and even to school after careful and intensive treatment. In the escaping-into-fantasy group, most of patients had personality traits which easily cause various troubles in their social relationships. This tendency of maladaptation to school life made them targets of bully. Their troublesome character became worse and more remarkable after many years of suffering from bully. They finally tried to deny their problems of maladjustment through fantasy in which they could enjoy themselves. Most of them returned to their social life after long therapeutic effort which included individual psychotherapy, family therapy and modulation of school environment. In the somatoform group, most patients enjoyed high level of adaptation in school life before incidents of bully. Treatment of this group was comparatively easy, because the relation between clinical symptoms and episodes of bully was evident. It was also easier to cooperate with parents and teachers in order to modulate school environment than in other groups. The symptoms of this group were usually transient and the patients returned to school in a short term. The patients showed various symptoms from psychotic level to neurotic level. School refusal was the common symptom or phenomenon in almost all cases.(ABSTRACT TRUNCATED AT 400 WORDS)