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Q&As

Bullying Associated With Depressive Symptoms in School-Going Adolescents

Dr Aedma.
Dr Kapil Aedma

In this Q&A, Kapil Aedma, MD, FAPA, Unity Point Medical Center, Peoria, Illinois, answers questions about his study "Association of Bullying Experiences With Depressive Symptoms and Psychosocial Functioning Among School Going Children and Adolescents" and discusses key takeaways for clinicians working with adolescents that are experiencing bullying.

Question: What led you and your colleagues to explore the relationship between adolescent bullying and depression?

Answer: There are several studies on the correlation between bullying and depressive symptoms of victims. In addition, an increasing number of cross-sectional surveys have found higher levels of depressive symptoms among school-going children who report bullying their peers.

According to bullying statistics 30% of US students in grades 6 through 10 are involved in moderate or frequent bullying—as bullies, as victims, or as both—according to the results of the first national school bullying statistics and cyberbullying survey. Because of this increase in prevalence of bullying we felt the need explore relationship of bullying and depression in school going children.

Q: Is there a correlation between adolescents who had pre-existing mental health disorders and experienced bullying?

A: Our study aimed to examine the association of bullying experience with depressive symptoms and the child’s ability to perform activities of daily living, engage in a relationship, and meet the demands of the community. A significant percentage of kids (72.7%) experienced emotional or behavioral difficulties, with the majority (66.6%) experiencing it for less than a month.

Depression, anxiety, low self-esteem, self-harming behavior (particularly in girls), alcohol and drug usage and dependence, hostility, and engagement in violence or crime (especially for boys) are among the psychological impacts of bullying. While bullying can affect any child's mental health, individuals who already have mental health concerns are more likely to be bullied and suffer severe consequences.

Q: The study results show depressive symptoms reported as mild, moderate, moderately severe, and severe. Is there concern that the severe symptoms will continue and potentially manifest to something even more threatening, such as major depressive disorder?

A: Adolescent who are affected by bullying are at increased risk of developing major depression that those who are not affected by bullying. One study found that the effects of bullying in children, including depression, can continue up to 40 years after. Bullying can cause many negative outcomes on mental health, and in extreme situations it can lead to suicide.

Q: What course of treatment would you recommend for adolescents subjected to bullying that leads to depressive symptoms?

A: The best treatment for adolescent depression is a combination of talk therapy (psychotherapy) and medications.

Q: In your personal experience with both adult and adolescent patients, what is the long-term impact of bullying on mental health? Does it follow a person into adulthood?

A: Children who are victims of bullying have consistently been found to be at increased risk for being diagnosed with anxiety disorders and depression as adults. They also have an increased risk of psychotic experience, suicidal ideations, attempts, and accomplished suicide. They have been reported to be in poor general health, including intensified physical pain, headaches, and delayed recovery for sicknesses as adults. They are said to have difficulty making and keeping friends, are less likely to live with their partners, and are less likely to receive social support. They were found to have lower levels of education and poor financial management. (10.1136/archdischild-2014-306667)

Q: What other insights or key takeaways would you like to share with other clinicians working with adolescents that are bullied?

A: Look for warning signs in children who are either being bullied, or bullying others is an important first step. These warnings signs may indicate other problems, like depression or substance use issues.

Children who are getting bullied often make excuses for not going to school, their grades may decline, they may loss interest in schoolwork. There may avoid of social situations and friends. They tend to isolate themselves. They may become increasingly irritable, threaten to harm themselves.

Children who are bullying others might get in frequent fights, defiant, keep blaming others for their actions and never take responsibility. They get in to trouble in school frequently.

References

Consequences of bullying. Stopbullying.gov. Accessed April 6, 2022.

Takizawa R, Maughan B, Arseneault L. Adult health outcomes of childhoos bullying victimization: evidence from a five-decade longitudinal British birth cohort. Am J Psychiatry. 2014;171(7):777-784. doi: 0.1176/appi.ajp.2014.13101401

Wolke D, Lereya ST. Long-term effects of bullying. Arch Dis Child. 2015;100(9):879-885. doi: 10.1136/archdischild-2014-306667


Kapil Aedma, MD, FAPA, is a board-certified child, adolescent, and adult psychiatrist at Unity Point Medical Center in Peoria, Illinois, currently and he is also an adjunct assistant professor in the department of psychiatry at the University of Illinois College of Medicine Peoria. He completed his psychiatry residency, and child and adolescent psychiatry fellowship from the Kansas University Medical Center in Kansas City, Kansas.

While his practice primarily focuses on medication management, he likes to utilize psychotherapy as well as other non-pharmacological methods to work collaboratively to achieve overall well-being.

His goal is to enhance patient care by incorporating innovative technologies in health care delivery. His research interests are telemedicine and how it can improve access to patient care.

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