PREVALENCE OF BULLYING AMONGST FIRST-EPISODE PSYCHOSIS PATIENTS AND UNAFFECTED CONTROLS

Abstract

Background:Despite increasing evidence suggesting that childhood mal-treatment is significantly associated with psychotic disorders, the role ofbullying in the later development of psychosis is still controversial (Kelle-her et al., 2008, Arseneault et al., 2011). Therefore, this study examinedthe prevalence of bullying amongst first-episode psychosis patients andunaffected controlsMethods:Data were collected from 227 first-presentation psychosis casesand 215 geographically-matched controls. Bullying was assessed as partof the Brief Life Events schedule. Patients and controls were shown acard listing 10 adverse events, including “bullying”, “sexual abuse”, “beingexpelled from school”, and asked whether they had ever experienced any ofthem during their life. Only positive responses on the bullying item for 5 ormore years ago were taken as evidence of having been a victim of bullyingin order to minimise the likelihood of psychotic symptoms occurring priorto the bullying exposure. Binary logistic regression was used to examineassociations between exposure to bullying and case-control status, and to test for interaction effects, while controlling for potential confounders. Thiswas done first with the full sample, and then stratified by gender, ethnicity,family history of psychiatric disorders, family history of psychosis, andcannabis use.Results:Compared with controls, first-presentation psychosis cases wereapproximately twice as likely to report experiences of bullying. The asso-ciation between bullying and psychosis case status was strongest amongstparticipants with no family psychiatric history. Amongst controls, thosethat reported at least one psychosis-like symptom were approximatelytwice as likely to report exposure to bullying as those without such symp-toms. Furthermore, significant associations were found between bullyingand having a psychotic disorder regardless of whether individuals hador had not used cannabis in their lifetime. No gender differences werefound for the association between bullying and either psychotic disorderor psychosis-like symptoms. Amongst the psychosis cases, those presentingwith a history of conduct problems were over two times more likely toreport experiences of bullying.Discussion:Our results suggest a strong association between experiencesof bullying and psychotic disorder. If replicated, these findings not onlyhave potentially important implications for furthering our understanding ofthe potential aetiology of psychosis, but also for the development of specificinterventions for children to prevent later mental health and behaviouralproblems.