Scenario

A 12-year-old boy, John, is seen with his mother. He has asthma, which is currently being treated with regular low dose inhaled corticosteroids and as required short-acting bronchodilator. At his outpatients review, he initially reports his symptoms are well controlled. However, he is found to have a higher fractional exhaled nitric oxide (100 ppb compared with 20 ppb) and a lower forced expiratory volume in 1 s (85% of predicted compared with 105% of predicted) than at his review 12 months ago. When challenged, his mother is unsure as to the cause of this deterioration. John explains that he does not like being different from his friends, and it emerges that John has been bullied and teased at school ‘because of his asthma’. His mother is shocked by this revelation.

Structured clinical question

Is there an association between having asthma and being bullied?

Search

We only included studies involving children and young people that contained data on both bullying and asthma as a specific diagnosis. We did not consider studies that reported data only on ‘chronic illness/disease’ or atopic diseases such as food allergy or eczema.

Cochrane Library: Nil.

Search on AMED, BNI, CINAHL, Embase, EMCARE, HMIC, Medline, PsycINFO, PubMed via HDAS using ((bullying AND (children OR childhood OR paediatrics OR child OR teenage OR adolescent)) AND asthma).ti,ab. found 36 articles, seven1–7 relevant, and using ((bullying AND (children OR childhood OR paediatrics OR child OR teenage OR adolescent)) AND (chronic disease OR chronic illness OR asthma)).ti,ab. 72 articles were returned with two additional studies.8 9 A further two additional relevant studies were identified10 11 through reference lists. All studies identified using original data are displayed in table 1 …