Bullying behavior in relation to psychiatric disorders and physical health among adolescents: A clinical cohort of 508 underage inpatient adolescents in Northern Finland

The aim was to investigate the association of bullying behavior with psychiatric disorders and physical health in a sample of adolescent psychiatric patients, as there have to our knowledge been no previous studies using actual psychiatric diagnoses examining this relationship in boys and girls. We studied 508 Finnish adolescents (age 12-17) admitted to psychiatric inpatient care between April 2001 and March 2006 from the geographically large area of Northern Finland. The Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime (K-SADS-PL) was used to obtain psychiatric diagnoses of adolescents according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and information on bullying behavior. Logistic regression analyses showed that having an externalizing disorder increased the likelihood of being a bully or a bully-victim (i.e. a person who is both a bully and a victim of bullying) among both the boys (odds ratio, OR=14.4, P=0.001) and the girls (OR=10.0, P<0.001). In addition, having an internalizing disorder increased the likelihood of being a victim of bullying among the boys (OR=3.4, P=0.008), but not the girls. Chronic somatic diseases were also significantly associated with being bullied among the boys (OR=2.5, P=0.041). Our results suggest that adolescents who are involved in bullying behavior should be evaluated psychiatrically, as this might be an early marker of psychiatric disorders.

[1]  Gitanjali Saluja,et al.  Prevalence of and risk factors for depressive symptoms among young adolescents. , 2004, Archives of pediatrics & adolescent medicine.

[2]  C. Hartgers,et al.  EuropASI: European Adaptation of a Multidimensional Assessment Instrument for Drug and Alcohol Dependence , 1995 .

[3]  C. Rissel,et al.  Bullying behaviour and psychosocial health among school students in New South Wales, Australia: cross sectional survey , 1999, BMJ.

[4]  R. Koenker,et al.  Quantile regression methods for reference growth charts , 2006, Statistics in medicine.

[5]  C. Gillberg,et al.  SafetyLit is a free service of the Center for Injury Prevention Policy and Practice at San Diego State University in collaboration with the World Health Organization. , 2006 .

[6]  Young Shin Kim,et al.  The reliability and validity of Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean version (K-SADS-PL-K). , 2004, Yonsei medical journal.

[7]  J. Juvonen,et al.  Sticks and Stones May Break My Bones, but Names Will Make Me Feel Sick: The Psychosocial, Somatic, and Scholastic Consequences of Peer Harassment , 2005, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[8]  M. Marttunen,et al.  Familial risks, conduct disorder and violence , 2006, European Child & Adolescent Psychiatry.

[9]  A. Sourander,et al.  What Is the Early Adulthood Outcome of Boys Who Bully or Are Bullied in Childhood? The Finnish “From a Boy to a Man” Study , 2007, Pediatrics.

[10]  Ersilia Menesini,et al.  Bullying and Victimization in Adolescence: Concurrent and Stable Roles and Psychological Health Symptoms , 2009, The Journal of genetic psychology.

[11]  K. Björkqvist,et al.  5 – The Development of Direct and Indirect Aggressive Strategies in Males and Females , 1992 .

[12]  N. Crick,et al.  Relational and Physical Forms of Peer Victimization in Preschool , 1999 .

[13]  Kellie Carlyle,et al.  Demographic differences in the prevalence, co-occurrence, and correlates of adolescent bullying at school. , 2007, The Journal of school health.

[14]  K. Björkqvist,et al.  Of Mice and Women: Aspects of Female Aggression , 1994, Politics and the Life Sciences.

[15]  N. Ryan,et al.  Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[16]  K. Kumpulainen.  Psychiatric conditions associated with bullying , 2008, International journal of adolescent medicine and health.

[17]  A. Rimpelä,et al.  Bullying at school--an indicator of adolescents at risk for mental disorders. , 2000, Journal of adolescence.

[18]  M. Timonen,et al.  Smoking and suicidality among adolescent psychiatric patients. , 2004, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[19]  A. Page,et al.  Obesity and bullying: different effects for boys and girls , 2005, Archives of Disease in Childhood.

[20]  P. Räsänen,et al.  Bullying Behavior Is Related to Suicide Attempts but Not to Self-Mutilation among Psychiatric Inpatient Adolescents , 2009, Psychopathology.

[21]  Ton Vogels,et al.  Do Bullied Children Get Ill, or Do Ill Children Get Bullied? A Prospective Cohort Study on the Relationship Between Bullying and Health-Related Symptoms , 2006, Pediatrics.

[22]  M. Fekkes,et al.  Bullying behavior and associations with psychosomatic complaints and depression in victims. , 2004, The Journal of pediatrics.

[23]  L Karstadt,et al.  Bullying involvement in primary school and common health problems , 2001, Archives of disease in childhood.

[24]  P. Ambrosini.  Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[25]  E. Gordon,et al.  Exposure to early life trauma is associated with adult obesity , 2006, Psychiatry Research.

[26]  M. Prinstein,et al.  Adolescent obesity, overt and relational peer victimization, and romantic relationships. , 2002, Obesity research.

[27]  M. Gould,et al.  Bullying, depression, and suicidality in adolescents. , 2007, Journal of the American Academy of Child and Adolescent Psychiatry.

[28]  A. Sourander,et al.  Childhood bullying as a risk for later depression and suicidal ideation among Finnish males. , 2008, Journal of affective disorders.

[29]  J B Carlin,et al.  Does bullying cause emotional problems? A prospective study of young teenagers , 2001, BMJ : British Medical Journal.

[30]  Irma Moilanen,et al.  Childhood bullying behavior and later psychiatric hospital and psychopharmacologic treatment: findings from the Finnish 1981 birth cohort study. , 2009, Archives of general psychiatry.

[31]  P. Räsänen,et al.  Suicidal behavior among adolescents with conduct disorder—the role of alcohol dependence , 2007, Psychiatry Research.

[32]  I. Janssen,et al.  Associations between overweight and obesity with bullying behaviors in school-aged children. , 2004, Pediatrics.

[33]  G. Gini,et al.  Association Between Bullying and Psychosomatic Problems: A Meta-analysis , 2009, Pediatrics.