Children who are bullied in school are more likely than others to develop depressive symptoms or other health problems, while children who already have these symptoms have a higher risk of being bullied, new study findings show.

“Our results show both: bullied children can get ill from the bullying, but also that some illnesses can lead to getting bullied,” co-author Dr. Minne Fekkes, of the Netherlands Organization of Applied Scientific Research in Leiden, Netherlands, told Reuters Health.

These findings may be of general interest because many elementary and high school students experience bullying, according to various studies. In a German study, eight percent of children reported being bullied at least once a week, as did 17 percent of children in a US study. In a study conducted in Italy, 30 percent of children reported that they had been bullied at least sometimes.

Studies have also shown an association between victimization and health symptoms such as depression, anxiety, bedwetting and headache. Whether those symptoms result from the bullying or precede the bullying had not been previously explored.

To investigate, Fekkes and colleagues conducted a six-month study with 1,118 children, ages 9 to 11, from 18 elementary schools in the Netherlands. The students completed a questionnaire in the fall of 1999 and were followed-up in the spring of 2000 to determine whether they had been bullied and how often the bullying had occurred in recent months. Students were considered to have been bullied if they experienced one of several incidents such as being called names by other students, being ignored, or if they had been hit or shoved by another student.

Overall, children who reported experiencing bullying at the beginning of the school year were up to four times more likely to develop symptoms of depression, anxiety, bedwetting, abdominal pain and tension during the school year, Fekkes and colleagues report in the May issue of Pediatrics.

“This supports the hypothesis that the stress of victimization causes the development of somatic and psychological health problems,” they write.

In some cases, however, psychological, but not physical, heath problems preceded the bullying.

Children who reported symptoms of depression or anxiety or who had a poor appetite at the start of the school year, were more likely to be bullied by the end of the school year than were their peers without these symptoms, the report indicates.

“Anxiety and depression may make a child appear more vulnerable and less capable of defending him (or) herself,” Fekkes explained. “Anxious or depressed children may therefore be an easier target for bullies,” the researcher added.

In light of the findings, parents should consider the possibility that their child is being bullied if he or she develops health problems, such as depression, abdominal pain, sleep problems or anxiety, Fekkes told Reuters Health, adding that “many children do not tell their parents that they are being bullied.”

“In addition,” Fekkes continued, “parents of depressed or anxious children may consider seeking help for their children from a counselor or school psychologist to improve their social skills, which may prevent victimization.

SOURCE: Pediatrics, May 2006.