Being bullied in elementary school, or being a bully and a victim, increases the risk of psychiatric diagnoses in adulthood, according research published in JAMA Psychiatry.
Andre Sourander, MD, PhD, of the University of Turku Department of Child Psychiatry in Finland, and colleagues compared exposure to bullying at 8 years old and adolescent or adult psychiatric diagnoses in 5,034 participants from five university hospital areas in Finland. The children and their parents and teachers filled out questionnaires in 1989 about the child’s exposure to bullying as a victim, bully or both (bully-victim). Parents and teachers also filled out behavior scale assessments to record children’s psychiatric symptoms at age 8.
The researchers collected data on any psychiatric diagnoses and then specific diagnoses for schizophrenia or other psychotic disorders, depression, anxiety, eating disorders or substance abuse disorders based on ICD-10 codes in participants’ inpatient or outpatient medical records between ages 16 and 29. Among 4,540 participants not involved in any bullying, 11.5% had a psychiatric diagnosis at follow-up. One in five frequent bullies (19.9%) had a psychiatric diagnosis, as well as 23.1% of frequent victims and 31.2% bully-victims.
After adjustment for sex, parent education and family structure, children who were bullies, victims or both had an increased risk for any psychiatric diagnosis and at least double the risk of depression compared to children without any bullying exposure. After adjusting for psychiatric symptoms at age 8, those bullied were 1.9 times more likely to have any psychiatric disorder and 1.9 times more likely to have depression. Bully-victims were 2.1 times more likely to have any psychiatric disorder after these adjustments. The increased risk for psychiatric disorders in adulthood among bullies only occurred if psychiatric symptoms were present at age 8.
“This result is in accordance with those of previous longitudinal studies showing that individuals with bullying–exposure to bullying behavior often have poor outcomes,” the authors wrote.
Though the study was prospective and longitudinal with a large sample size, it did not address possible mechanisms explaining how bullying leads to psychiatric disorders. The study also did not address bystanders to bullying, assess the type of bullying that occurred or account for factors such as “parenting style, family functioning and biological, genetic, and other environmental factors,” the authors noted.
Sourander A, et al. Association of Bullying Behavior at 8 Years of Age and Use of Specialized Services for Psychiatric Disorders by 29 Years of Age. JAMA Psychiatry. 2015; doi:10.1001/jamapsychiatry.2015.2419.