Study Examines Association Between Childhood Bullying and Later Psychiatric Hospitalization, Treatment


 
Childhood bullying and victimization appear to predict future psychiatric problems in both males and females although females appear more likely to be affected regardless of pre-existing psychiatric problems, according to a report in the September issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

“Bullying can be defined as an aggressive act embodying an imbalance of power in which the victims cannot defend themselves accompanied by an element of repetition,” according to background information in the article. “Bullying and victimization are associated with poorer family functioning, interparental violence and parental maltreatment” and often result in troubled outcomes for both bullies and victims. Although there have been studies on the effects of bullying, “there are no previous population-based studies that examined late adolescence or adulthood outcomes of childhood bullying among both males and females.”

Andre Sourander, M.D., Ph.D., of Turku University Hospital, Turku, Finland, and colleagues studied associations between bullying and victimization in childhood (at age 8) and later psychiatric hospitalization and treatment with antipsychotic medication (from ages 13 to 24) in 5,038 Finnish children who participated in the nationwide Finnish 1981 Birth Cohort Study. Information was gathered from parents, teachers, participants’ self-reports and a national register of hospital and medication records.

In total, 6 percent of 8-year-old boys bullied others frequently, but were not victims themselves, while 6.4 percent of boys were frequently victims but not bullies. Additionally, 2.8 percent of boys were frequently both bullies and victims. Among girls, 3.6 percent were frequent victims of bullying, 0.6 percent were bullies and 0.2 percent were both bullies and victims.

“Frequent victim status at age 8 years among females independently predicted psychiatric hospital treatment and use of antipsychotic, antidepressant and anxiolytic drugs” regardless of psychiatric problems at baseline, the authors write. “Among males, frequent bully-victim and bully-only statuses predicted use of antidepressant and anxiolytic drugs. Frequent bully-victim status among males also predicted psychiatric hospital treatment and use of antipsychotics. However, when the analysis was controlled with total psychopathology score at age 8 years, frequent bully, victim or bully-victim status did not predict any psychiatric outcomes among males.”

Bullying behavior should be considered an indicator of the risk of a future psychiatric disorder, which may develop into a serious problem for those involved and for society in general, the authors note.

“Developing prevention systems requires a knowledge of the biological, psychological and social mechanisms involved. As later psychological disorders have been found to be associated with individuals displaying childhood bullying behaviors, there is a need for the integration of mental health services into the school context,” the authors conclude. “It is important to inform policymakers, school professionals and the public about the potential short-term and long-term consequences of bullying and victimization.”

Arch Gen Psychiatry. 2009;66[9]:1005-1012.