title: Adult psychiatric outcomes of bullying and being bullied by peers in childhood and adolescence.
abstract: OBJECTIVE
  Both bullies and victims of bullying are at risk for psychiatric problems in childhood, but it is unclear if this elevated risk extends into early adulthood.
  
  
  OBJECTIVE
  To test whether bullying and/or being bullied in childhood predicts psychiatric problems and suicidality in young adulthood after accounting for childhood psychiatric problems and family hardships.
  
  
  METHODS
  Prospective, population-based study.
  
  
  METHODS
  Community sample from 11 counties in Western North Carolina.
  
  
  METHODS
  A total of 1420 participants who had being bullied and bullying assessed 4 to 6 times between the ages of 9 and 16 years. Participants were categorized as bullies only, victims only, bullies and victims (hereafter referred to as bullies/victims), or neither.
  
  
  METHODS
  Psychiatric outcomes, which included depression, anxiety, antisocial personality disorder, substance use disorders, and suicidality (including recurrent thoughts of death, suicidal ideation, or a suicide attempt), were assessed in young adulthood (19, 21, and 24-26 years) by use of structured diagnostic interviews. RESULTS Victims and bullies/victims had elevated rates of young adult psychiatric disorders, but also elevated rates of childhood psychiatric disorders and family hardships. After controlling for childhood psychiatric problems or family hardships, we found that victims continued to have a higher prevalence of agoraphobia (odds ratio [OR], 4.6 [95% CI, 1.7-12.5]; P < .01), generalized anxiety (OR, 2.7 [95% CI, 1.1-6.3]; P < .001), and panic disorder (OR, 3.1 [95% CI, 1.5-6.5]; P < .01) and that bullies/victims were at increased risk of young adult depression (OR, 4.8 [95% CI, 1.2-19.4]; P < .05), panic disorder (OR, 14.5 [95% CI, 5.7-36.6]; P < .001), agoraphobia (females only; OR, 26.7 [95% CI, 4.3-52.5]; P < .001), and suicidality (males only; OR, 18.5 [95% CI, 6.2-55.1]; P < .001). Bullies were at risk for antisocial personality disorder only (OR, 4.1 [95% CI, 1.1-15.8]; P < .04).
  
  
  CONCLUSIONS
  The effects of being bullied are direct, pleiotropic, and long-lasting, with the worst effects for those who are both victims and bullies.
authors: Department of Psychiatry and Behavioral Sciences, Center for Developmental Epidemiology, Duke University Medical Center, Durham, North Carolina 27710, USA. william.copeland@duke.edu
authors: William E
authors: WE
authors: Copeland
authors: Dieter
authors: D
authors: Wolke
authors: Adrian
authors: A
authors: Angold
authors: E Jane
authors: EJ
authors: Costello
mesh_terms: D000293:Adolescent; D000328:Adult; D058445:Bullying / Q000523:psychology*; D002648:Child; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology* / Q000523:psychology; D010379:Peer Group; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D055815:Young Adult