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Bullying exposure in childhood linked to severe psychiatric outcomes in adulthood

Exposure to bullying in childhood, even without childhood psychiatric symptoms, was associated with severe psychiatric outcomes in adulthood that required treatment, according to recent findings.

“An increasing amount of evidence suggests that bullying and exposure to bullying contribute to later mental health problems. However, only a few large-scale longitudinal prospective studies examine whether the effects of bullying behavior in childhood extend into adulthood and whether preexisting behavioral and emotional problems or bullying per se explain adult outcomes,” Andre Sourander, MD, PhD, of University of Turku, Finland, and colleagues wrote.

To study associations between bullying behavior in childhood and adult psychiatric outcomes, researchers followed a nationwide birth cohort study of 5,034 Finnish children from age 8 to 29 years. Bullying, exposure to bullying and psychiatric symptoms were determined via self-reports from parents, teachers and children when children were aged 8 years. Use of specialized services for psychiatric disorders from age 16 to 29 years was determined via a nationwide hospital register.

Overall, 90.2% of participants did not engage in bullying. Of these, 11.5% received a psychiatric diagnosis at follow-up.

Psychiatric diagnoses at follow-up occurred among 19.9% of participants who engaged in frequent bullying, 23.1% of those frequently exposed to bullying and 31.2% of those frequently engaged in and exposed to bullying.

When adjusting for sex, family factors and child psychiatric problems at age 8 years, there were independent associations between treatment of any psychiatric disorder with frequent exposure to bullying (HR = 1.9; 95% CI, 1.4-2.5) and being a bully with exposure to bullying (HR = 2.1; 95% CI, 1.3-3.4).

Bullying was associated with adult psychiatric outcomes only if psychiatric problems were present at age 8 years.

Participants who were bullies with exposure to bullying at age 8 years had high risk for several psychiatric disorders requiring treatment in adulthood, however, associations with specific psychiatric disorders did not remain significant when controlling for concurrent psychiatric symptoms.

“With regard to prevention and treatment, school authorities should consider integrating preventive efforts for bullying and psychiatric problems. Parents, teachers and pediatricians need to be educated about the association between bullying involvement and psychiatric outcomes so as to screen and intervene if needed,” Sourander and colleagues wrote. “Exposure to bullying is a form of abuse that should be addressed effectively even when other problems do not exist. Policy makers and health care professionals should be aware of the complex nature between bullying and psychiatric outcomes when they implement prevention and treatment interventions.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.