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

Petros Skapinakis,Konstantina Magklara,Venetsanos Mavreas,Stefanos Bellos,Stelios Stylianidis,Glyn Lewis,Ricardo Araya,Tatiana Gkatsa

doi:10.1186/1471-244x-11-22

Petros Skapinakis, Konstantina Magklara + Show 6 more

Open Access

https://doi.org/10.1186/1471-244x-11-22

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Abstract

BackgroundBullying 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.Methods5614 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.ResultsVictims 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.ConclusionsThe 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.

Highlights

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 assessed by means of a detailed structured interview
An increase in the frequency of victimization was associated with a higher prevalence of suicidal ideation while this was much weaker in students that bullied others (p = 0.09)

Summary

Introduction

Bullying in schools has been associated with suicidal ideation but the confounding effect of psychiatric morbidity has not always been taken into account. There is some controversy in the literature about the relative associations of the different types of bullying behavior with suicidal ideation: most studies support that victims are more likely to report suicidal thoughts compared to perpetrators, while other studies have found that those who are both victims and perpetrators have the highest risk [13,14,15,17,19,25,26]. The latter implies an interaction between victims and perpetrators but most studies reporting this higher risk did not formally test for statistical interaction with appropriate methods

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