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Findings From the Finnish 1981 Birth Cohort Study

Andre Sourander, MD, PhD; John Ronning, PhD; Anat Brunstein-Klomek, PhD; David Gyllenberg, MD; Kirsti Kumpulainen, MD; Solja Niemelä, MD, PhD; Hans Helenius, MSc; Lauri Sillanmäki, BA; Terja Ristkari, MNSc; Tuula Tamminen, MD; Irma Moilanen, MD, PhD; Jorma Piha, MD, PhD; Fredrik Almqvist, MD, PhD

Arch Gen Psychiatry. 2009;66(9):1005-1012.

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.

Author Affiliations: Regional Center of Child and Adolescent Psychiatry (Dr Sourander) and Department of Pediatrics (Dr Ronning), Institute of Clinical Medicine, Tromsö University, Tromsö, Norway; Department of Child and Adolescent Psychiatry, Columbia University, New York, New York (Drs Sourander and Brunstein-Klomek); Department of Child Psychiatry, Turku University Hospital, Turku, Finland (Drs Sourander and Piha); Department of Child Psychiatry, Helsinki University, Helsinki, Finland (Dr Gyllenberg); Department of Child Psychiatry, Kuopio University Hospital, Kuopio, Finland (Dr Kumpulainen); Departments of Psychiatry (Dr Niemelä and Ms Ristkari), Biostatistics (Mr Helenius), and Biostatistics (Ms Sillanmäki), Turku University, Turku; Department of Child Psychiatry, Tampere University and University Hospital, Tampere, Finland (Dr Tamminen); Department of Child Psychiatry, Oulu University Hospital, Oulu, Finland (Dr Moilanen); and Department of Child Psychiatry, Helsinki University Hospital, Helsinki (Dr Almqvist).

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