Context: No prospective population-based study examining predictive associations between childhood bullying behavior and long-term mental health outcomes in both males and females exists.
Objective: To study predictive associations between bullying and victimization in childhood and later psychiatric hospital and psychopharmacologic treatment.
Design: Nationwide birth cohort study from age 8 to 24 years.
Participants: Five thousand thirty-eight Finnish children born in 1981 with complete information about bullying and victimization at age 8 years from parents, teachers, and self-reports.
Main outcome measures: National register-based lifetime information about psychiatric hospital treatments and psychopharmacologic medication prescriptions.
Results: When controlled for psychopathology score, frequent victim status at age 8 years among females independently predicted psychiatric hospital treatment and use of antipsychotic, antidepressant, and anxiolytic drugs. Among males, frequent bully-victim and bully-only statuses predicted use of antidepressant and anxiolytic drugs. Frequent bully-victim status among males also predicted psychiatric hospital treatment and use of antipsychotics. However, when the analysis was controlled with total psychopathology score at age 8 years, frequent bully, victim, or bully-victim status did not predict any psychiatric outcomes among males.
Conclusions: Boys and girls who display frequent bullying behavior should be evaluated for possible psychiatric problems, as bullying behaviors in concert with psychiatric symptoms are early markers of risk of psychiatric outcome. Among females, frequent childhood victimization predicts later psychiatric problems irrespective of psychiatric problems at baseline.