Abstracts from BMJ No. 7048 Volume 313
Saturday 6 July 1996


BMJ No. 7048 Volume 313 Saturday 6 July 1996



Association of common health symptoms with bullying in primary school children

Katrina Williams, Mike Chambers, Stuart Logan, Derek Robinson

Abstract

Objectives - To estimate the prevalence of bullying in primary school children and to examine its association with common symptoms in childhood.

Design - Semistructured health interview conducted by school nurses as part of a school medical. {abspara}Setting--Newham, east London.

Subjects - All children in year 4 of school during the academic year 1992-93.

Main outcome measures - Reported bullying and common health symptoms.

Results - 2962 children (93.1% of those on the school roll) were interviewed (ages 7.6 to 10.0 years). Information about bullying was not recorded for 114 children. 22.4% (95% confidence interval 20.9 to 24.0) of children for whom information was available reported that they had been bullied. There was an association between children reporting being bullied sometimes or more often and reporting not sleeping well (odds ratio 3.6, 2.5 to 5.2), bed wetting (1.7, 1.3 to 2.4), feeling sad (3.6, 1.9 to 6.8), and experiencing more than occasional headaches (2.4, 1.8 to 3.4) and tummy aches (2.4, 1.8 to 3.3). A significant trend for increasing risk of symptoms with increased frequency of bullying was shown for all reported health symptoms (P\h0.001).

Conclusions - Health professionals seeing primary schoolchildren who present with headaches, tummy ache, feeling sad or very sad, bed wetting, and sleeping difficulties should consider bullying as a possible contributory factor.

Department of Epidemiology and Medical Statistics,
St Bartholomew's and Royal London School of Medicine and Dentistry,
Queen Mary and Westfield College,
London E1 4NS

Katrina Williams, lecturer
Mike Chambers, lecturer

Department of Epidemiology,
Institute of Child Health,
London WC1N 1EH

Stuart Logan, senior lecturer

Newham Health Care,
Beacontree House,
London E15 4EE

Derek Robinson, consultant community paediatrician

Correspondence to: Dr Logan.


Career preferences of doctors who qualified in the United Kingdom in 1993 compared with those of doctors qualifying in 1974, 1977, 1980, and 1983

Trevor W Lambert, Michael J Goldacre, Carol Edwards, James Parkhouse

Abstract

Objective - To report the career preferences of doctors who qualified in the United Kingdom in 1993 and to compare their choices with those of earlier cohorts of qualifiers.

Design - Postal questionnaires with structured questions, including questions about choice of future long term career, were sent to doctors a year after qualification.

Setting - United Kingdom. {abspara}Subjects--All medical qualifiers of 1993, comparing their replies with those from earlier studies of the qualifiers of 1974, 1977, 1980, and 1983.

Main outcome measures - Choice of future long term career and certainty of choice expressed at the end of the first year after qualification.

Results - Questionnaires were sent to 3657 doctors. 2621 (71.7%) replied. Of the 2621 respondents, 70.5% (1849) stated that their first preference was for a career in hospital practice, 25.8% (677) specified general practice, 1.0% (25) specified public health medicine or community health, 1.4% (36) specified careers outside medicine, and 1.3% (34) did not state a choice. By contrast, 44.7% (1416/3168) of the doctors in the 1983 cohort had specified that their first preference was general practice. Among the 1993 qualifiers, general practice was the first career choice of 17.5% of men (227/1297) and 34.0% of women (450/1324). Only 7.4% of men (96/1297) stated that they definitely wanted to enter general practice. Only 7.8% (103/1324) of women qualifiers in 1993 expressed a career preference for surgical specialties. Within hospital practice, comparing 1993 with 1983, choices for the medical specialties and for accident and emergency medicine rose and those for pathology fell. Women were less definite than men about their choice of future long term career.

Conclusions - If the 1993 cohort is typical of the current generation of young doctors, there has been a substantial shift away from general practice as a career choice expressed at the end of the preregistration year. General practice was much more popular among women than men. Few women opted for surgery. The sex imbalance in the percentage of doctors who choose different mainstreams of medical practice seems set to continue.

Medical Careers Research Group,
Unit of Health Care Epidemiology,
Department of Public Health and Primary Care,
University of Oxford,
Oxford OX3 7LF

Trevor W Lambert, statistician
Michael J Goldacre, director
Carol Edwards, research officer
James Parkhouse, study consultant

Correspondence to:Dr Goldacre.


Long term outcome of patients with neurotic illness in general practice

Keith R Lloyd, Rachel Jenkins, Anthony Mann

Abstract

Objective - To determine the 11 year outcome of neurotic disorder in general practice.

Design - Cohort study over 11 years.

Setting - Two general practices in Warwickshire England.

Subjects - 100 patients selected to be representative of those identified nationally by general practitioners as having neurotic disorders.

Main outcome measures - Mortality, morbidity, and use of health services.

Results - At 11 years 87 subjects were traced. The 11 year standardised mortality ratio was 173 (95% confidence interval 164 to 200). 47 were cases on the general health questionnaire, 32 had a relapsing or chronic psychiatric course, and 49 a relapsing or chronic physical course. Treatment for psychiatric illness was mainly drugs. The mean number of consultations per year was 10.8 (median 8.7). A persistent psychiatric diagnosis at one year follow up was associated with high attendance (>12 visits a year for 11 years) at follow up after age, sex, and physical illness were adjusted for. Severity of psychiatric illness (general health questionnaire score) at outset predicted general health questionnaire score at 11 year follow up, course of psychiatric illness, and high consultation rate.

Conclusion - These data support the view that a neurotic illness can become chronic and is associated with raised mortality from all causes and high use of services. Such patients need effective intervention, particularly those with a more severe illness who do not recover within one year.

Mental Health Research Unit,
University of Exeter,
Exeter EX2 5DW

Keith R Lloyd, senior lecturer

Institute of Psychiatry,
De Crespigny Park,
London SE5 8AF

Rachel Jenkins, senior lecturer
Anthony Mann, professor of epidemiological psychiatry

Correspondence to: Dr Lloyd.

k.r.lloyd@exeter.ac.uk

BMJ 1996;313:26-8



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