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      The association between bullying and early stages of suicidal ideation in late adolescents in Greece

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          Abstract

          Background

          Bullying in schools has been associated with suicidal ideation but the confounding effect of psychiatric morbidity has not always been taken into account. Our main aim was to test the association between bullying behavior and early stages of suicidal ideation in a sample of Greek adolescents and to examine whether this is independent of the presence of psychiatric morbidity, including sub-threshold symptoms.

          Methods

          5614 pupils 16-18 years old and attending 25 senior high schools were screened in the first phase and a stratified random sample of 2431 were selected for a detailed interview at the second phase. Psychiatric morbidity and suicidal ideation were assessed with the revised Clinical Interview Schedule (CIS-R) while bullying was assessed with the revised Olweus bully/victim questionnaire.

          Results

          Victims of bullying behavior were more likely to express suicidal ideation. This association was particularly strong for those who were bullied on a weekly basis and it was independent of the presence of psychiatric morbidity (Odds Ratio: 7.78; 95% Confidence Interval: 3.05 - 19.90). In contrast, being a perpetrator ("bullying others") was not associated with this type of ideation after adjustment. These findings were similar in both boys and girls, although the population impact of victimization in the prevalence of suicidal ideation was potentially higher for boys.

          Conclusions

          The strong cross-sectional association between frequent victimization and suicidal ideation in late adolescence offers an opportunity for identifying pupils in the school setting that are in a higher risk for exhibiting suicidal ideation.

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          Most cited references33

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          Bullying, depression, and suicidality in adolescents.

          To assess the association between bullying behavior and depression, suicidal ideation, and suicide attempts among adolescents. A self-report survey was completed by 9th- through 12th-grade students (n = 2342) in six New York State high schools from 2002 through 2004. Regression analyses were conducted to examine the association between being victimized and bullying others with depression, ideation, and attempts. Approximately 9% of the sample reported being victimized frequently, and 13% reported bullying others frequently. Frequent exposure to victimization or bullying others was related to high risks of depression, ideation, and suicide attempts compared with adolescents not involved in bullying behavior. Infrequent involvement in bullying behavior also was related to increased risk of depression and suicidality, particularly among girls. The findings indicate that both victims and bullies are at high risk and that the most troubled adolescents are those who are both victims and bullies. Psychopathology was associated with bullying behavior both in and away from school. Victimization and bullying are potential risk factors for adolescent depression and suicidality. In evaluations of students involved in bullying behavior, it is important to assess depression and suicidality.
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            Bullying at school--an indicator of adolescents at risk for mental disorders.

            A number of 14-16 year old Finnish adolescents taking part in the School Health Promotion Study (n=8787 in 1995, n=17643 in 1997) were surveyed about bullying and victimization in relation to psychosomatic symptoms, depression, anxiety, eating disorders and substance use. A total of 9 per cent of girls and 17 per cent of boys were involved in bullying on a weekly basis. Anxiety, depression and psychosomatic symptoms were most frequent among bully-victims and equally common among bullies and victims. Frequent excessive drinking and use of any other substance were most common among bullies and thereafter among bully-victims. Among girls, eating disorders were associated with involvement in bullying in any role, among boys with being bully-victims. Bullying should be seen as an indicator of risk of various mental disorders in adolescence. Copyright 2000 The Association for Professionals in Services for Adolescents.
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              Bullying, depression, and suicidal ideation in Finnish adolescents: school survey.

              To assess the relation between being bullied or being a bully at school, depression, and severe suicidal ideation. A school based survey of health, health behaviour, and behaviour in school which included questions about bullying and the Beck depression inventory, which includes items asking about suicidal ideation. Secondary schools in two regions of Finland. 16 410 adolescents aged 14-16. There was an increased prevalence of depression and severe suicidal ideation among both those who were bullied and those who were bullies. Depression was equally likely to occur among those who were bullied and those who were bullies. It was most common among those students who were both bullied by others and who were also bullies themselves. When symptoms of depression were controlled for, suicidal ideation occurred most often among adolescents who were bullies. Adolescents who are being bullied and those who are bullies are at an increased risk of depression and suicide. The need for psychiatric intervention should be considered not only for victims of bullying but also for bullies.
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                Author and article information

                Journal
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central
                1471-244X
                2011
                8 February 2011
                : 11
                : 22
                Affiliations
                [1 ]Department of Psychiatry, University of Ioannina, School of Medicine, Ioannina, Greece
                [2 ]Academic Unit of Psychiatry, School of Social and Community Medicine, University of Bristol, Bristol, UK
                [3 ]Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
                Article
                1471-244X-11-22
                10.1186/1471-244X-11-22
                3042930
                21303551
                30277c60-25c0-41b9-b8c9-d871e093feea
                Copyright ©2011 Skapinakis et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 September 2010
                : 8 February 2011
                Categories
                Research Article

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

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