Suicidal attempt of a schoolgirl to demonstrate against the school

Suicidal attempt of a schoolgirl to demonstrate against the school

CLINIAL NOTES – DONIESIENIA KLINICZNE
Jacek SEIN ANAND
Zygmunt CHODOROWSKI
Suicidal attempt of a schoolgirl
to demonstrate against the school teacher
and try to make her quit the school
Demonstracyjna próba samobójcza uczennicy
w celu zwolnienia z pracy nauczycielki
Katedra i Klinika Chorób Wewnêtrznych,
Geriatrii i Toksykologii Klinicznej
Akademii Medycznej w Gdañsku
Kierownik:
Prof. dr hab. med. Zygmunt Chodorowski
Additional key words:
suicidal attempt
demonstration
conflict at school
Dodatkowe s³owa kluczowe:
próba samobójcza
demonstracja
konflikt w szkole
Adres do korespondencji:
Dr n. med. Jacek Sein Anand
Katedra i Klinika Chorób Wewnêtrznych,
Geriatrii i Toksykologii Klinicznej
80-211 Gdañsk, ul. Dêbinki 7
Tel./fax: 058 349 28 32
e-mail: [email protected]
Przegl¹d Lekarski 2007 / 64 / 4-5
A case of a 16-year-old schoolgirl
who had admitted a demonstrative
suicide attempt against her school
teacher thus trying to make the teacher
leave the school has been presented.
During the observation period in the
Emergency Department the nurse taking care of the patient overheard that
during her talks with the friends, the
girl had been continuously urging
them to swallow the same set of tablets, call the ambulance and get admitted to the hospital. The anamnesis revealed that three schoolmates decided
to get rid of one of the teacher from
their school by accusing her of mental
cruelty which had led them to suicidal
attempts. It was done mainly because
of the bad marks they had got from the
teacher. The idea was undertaken by
our patient due to many news transmitted in the newspapers and television during last months in which the
teachers were blamed for a lot of incidents which had taken place in different schools in Poland. Despite the fact
that in many of these events the teachers were both physically and mentally
tormented by the pupils the opinions
presented by mass-medias were always against them. Our patient said
that in such circumstances it was supposed to be an easy way to solve all
the problems with unlike teacher. Conclusions: The physicians should pay
more attention on suicidal attempts
causes specially in adolescents. Adolescents possess poor knowledge of
the lethal potential of drugs, specially
over-the-counter medications. The
media have to take more responsibility for transmitting news concerning
youth which should be more honest
and verified.
Introduction
A case of a 16-year-old schoolgirl who
had admitted a demonstrative suicide attempt against her school teacher thus trying to make the teacher leave the school
has been presented.
W pracy przedstawiono przypadek
16-letniej uczennicy, która zosta³a przyjêta do szpitala z powodu demonstracyjnej próby samobójczej, która mia³a
na celu zwolnienie z pracy jej nauczycielki. Podczas obserwacji w szpitalu
pielêgniarka us³ysza³a jak pacjentka,
podczas rozmowy z dwiema kole¿ankami, usilnie namawia je do przyjêcia
identycznego zestawu tabletek, wezwania pomocy oraz zg³oszenia do
szpitala. W trakcie wywiadu okaza³o
siê, ¿e trzy uczennice zdecydowa³y siê
na demonstracyjn¹ próbê samobójcz¹
w celu oskar¿enia swojej nauczycielki
o molestowanie psychiczne, które mia³o spowodowaæ targniêcie siê na w³asne ¿ycie. Przyczyn¹ powy¿szego kroku by³y z³e oceny, które otrzyma³y od
nauczycielki. Pomys³ pozbycia siê nauczycielki uczennice podjê³y z powodu faktu, ¿e w ci¹gu ostatnich miesiêcy media oskar¿a³y nauczycieli o liczne negatywne zdarzenia, które mia³y
miejsca w szkole. Pomimo tego, ¿e w
wielu przypadkach to w³aœnie nauczyciele byli psychicznie i fizycznie molestowani przez swoich uczniów, opinia
kreowana przez masmedia by³a zawsze po stronie uczniów. Pacjentka
uwa¿a³a, ¿e w takich okolicznoœciach
podjêta przez nie demonstracyjna próba samobójcza bêdzie stosunkowo
pewnym i ³atwym sposobem pozbycia
siê nauczycielki. Wnioski: Lekarze powinni zwracaæ szczególn¹ uwagê na
skrywane przyczyny prób samobójczych podejmowanych przez osoby
m³ode. M³odzie¿ posiada niewielk¹
wiedzê na temat toksycznoœci przyjmowanych leków, w tym leków sprzedawanych bez recepty. Media powinny wzi¹æ na siebie wiêksz¹ odpowiedzialnoœæ za przekazywane informacje
o m³odzie¿y, które powinny byæ uczciwe i rzetelne.
Case report
In December 2006, a 16-year-old schoolgirl was
admitted to the Emergency Department of the Medical
University of Gdañsk because of suicidal attempt. She
admitted that she had swallowed approximately 8 tablets of Panadol (á 500 mg of paracetamol), 2 tablets of
355
Ascofer (á 24 mg of Fe++), and 3 tablets of Magnezin (á
52 mg of Mg). On admission to the hospital the patient
was alert and did not report any complains. Vital signs
were as follows: pulse 80 beats/min, blood pressure 130/
80 mmHg, respiratory rate 22 breathes/min, and temperature 36,6°C. Examination of the head, eyes, ears,
nose, and throat was within the normal limits. The neck
was supple. The cardiac, lung, abdominal and skin examinations were unremarkable. Neurological examination revealed an alert and well oriented female without
any abnormalities. There were also no significant abnormalities in basic biochemical tests results. During the
observation period in the Emergency Department the
patient was more and more nervous and all the time kept
on talking and sending sms-es to her two schoolmates
on the mobile phone. The nurse taking care of the patient overheard that during her talks with the friends, the
girl had been continuously urging them to swallow the
same set of tablets, call the ambulance and get admitted to the hospital. After reporting this problem to the
doctor the children's psychologist was called immediately.
The anamnesis revealed that three schoolmates decided to get rid of one of the teacher from their school by
accusing her of mental cruelty which had led them to
suicidal attempts. It was done mainly because of the bad
marks they had got from the teacher. Fortunately two
other girls were afraid of taking the drugs and that made
our patient rather angry. As such she helped the medical
staff by giving them the real motive of the suicidal attempt. According to our patient the drugs as well as the
doses were chosen in a way to avoid any harm to the
attempters, however, the dose of acetaminophen was
very small only because of the lack of the tablets at home.
The planned dose of acetaminophen was higher and was
to reach about 20 tablets. The idea to get rid of the teacher
in such a way was caused mainly by Polish media and
officials who always blamed the teachers in case of any
incidents which had taken place at school. Our patient
had only supportive treatment, and after 10 hours of observation she was discharged. All circumstances of her
suicidal attempt as well as persuading schoolmates to
do the same were reported to the Police.
Discussion
Despite mixed trends observed around
the world in suicide rate in rising generation, such incidents remain an important
public health problem [1,2,5,10]. Adolescent
suicide is also a leading cause of mortality
356
among adolescents [5]. According to
Hamilton-Obaid approximately 5 170 youngsters between the age of 15 and 20 took
their lives in the 90-ies in USA [2]. We know
many predictors for suicidal ideation in adolescents like alcohol and drug use, television and video violence, socio-economic
status, easy access to weapons, previous
suicidal attempts, and similar incidents in the
close family, mental illness, isolation, stress,
history of physical and psychological abuse,
and problems at school [5,7,9]. Little is
known, however, about the usage of suicidal
attempts in obtaining by the adolescents
their own aims specially those which additionally harm other people.
There are two aspects which should be
discussed in our case. The first one is connected with the conception of such step,
while the second is related to the safety of
drug using in demonstrative suicidal attempts done by the adolescents.
The idea was undertaken by our patient
due to many news transmitted in the newspapers and television during last months in
which the teachers were blamed for a lot of
incidents which had taken place in different
schools in Poland. Despite the fact that in
many of these events the teachers were both
physically and mentally tormented by the
pupils, the opinions presented by massmedias were always against them. Our patient said that in such circumstances it was
supposed to be an easy way to solve all the
problems with unlike teacher.
Our patient was convinced that types
and doses of medications were completely
harmless. Her opinion was based on advice
obtained by her schoolmates and because
over-the-counter (OTC) medications remain
freely available to the patients [6]. Unfortunately many authors show that about 42%
of adolescents underestimate the potential
lethality of acetaminophen in overdose, 50%
underestimate the dose to cause death,
whereas 17% do not believe that one could
Przegl¹d Lekarski 2007 / 64 / 4-5
ingest enough acetaminophen to cause
death [3,4,8].
According to the best of our knowledge
we have not found any medical article similar to the case described above.
Conclusions
The physicians should pay more attention on suicidal attempts causes specially
in adolescents.
Adolescents possess poor knowledge of
the lethal potential of drugs, specially overthe-counter medications.
The media have to take more responsibility for transmitting news concerning youth
which should be more honest and verified.
References
1. Enggvist U., Rydelius P.A.: Death and suicide
among former child and adolescent psychiatric patients. BMC Psychiatry 2006, 6, 51.
2. Hamilton-Obaid B.: Helping adolescents in crisis: a
case study. Adolescence 1989, 24, 59.
3. Harris H.E., Myers W.C.: Adolescents' misperception of the dangerous of acetaminophen in overdose.
Suicide Life Threat. Behav. 1997, 27, 274.
4. Huott M.A., Storrow A.B.: A survey of adolescents'
knowledge regarding toxicity of over-the-counter
medications. Acad. Emerg. Med. 1997, 4, 214.
5. Kirkcaldy B.D., Siefen G.R., Urkin J., Merrick J.:
Risk factor for suicidal behavior in adolescents.
Minerva Pediatr. 2006, 58, 443.
6. Lo A., Shalansky S., Leung M. et al.: Patient characteristics associated with nonprescription drug use
in intentional overdose. Can. J. Psychiatry 2003, 48,
232.
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adolescents' knowledge of its potential for toxicity. J.
Am. Acad. Child Adolesc. Psychiatry 1992, 31, 686690.
9. Park H.S., Schepp K.G., Jang E.H., Koo H.Y.: Predictors of suicidal ideation among high school students by gender in South Korea. J. Sch. Health 2006,
76, 181.
10. Sharma B.R., Gupta M., Sharma A.K. et al.: Suicides in Northern India: Comparison of trends and
review of literature. J. Clin. Forensic Med. 2006, Nov
15; [Epub ahead of print]
J. Sein Anand i Z. Chodorowski