BOSTON – Children singled out for abuse either in person or through cyberbullying are more prone to long-term depression, significantly poorer mental and physical health, and suicidal thoughts and actions than their peers who are spared from bullying, said investigators at the annual meeting of the American Academy of Psychiatry and the Law.

Children seen as outsiders by their peers – those with developmental disabilities, mental health problems, and gays or lesbians – are the most common targets of bullies both in the schoolyard and online, said Dr. Eileen P. Ryan from the University of Virginia in Charlottesville.

With cyberbullying – a term that encompasses remote, electronic bullying done on e-mail, role-playing game sites, YouTube, Facebook, and other online venues – the perpetrator doesn’t need to be in the same room or the same town as the victim. In addition, the bully can be physically weaker than his target.

"This is where the little red-headed, freckled, pale child is able to bully the quarterback of the high school football team," said Dr. Bradley Freeman of Vanderbilt University in Nashville, Tenn.

Dr. Ryan cited a definition of bullying by Dan Olweus, Ph.D., a Swedish psychologist and bullying expert: "A person is bullied when he or she is subjected repeatedly and over time to negative action on the part of one or more people."

The U.S. attorney general’s office defines cyberbullying as "use of electronic devices and information such as e-mail instant messaging, text messages, mobile phones, pager, and websites to send or post cruel or harmful messages or images about an individual or group."

Both forms of bullying can have severe mental health consequences for both the victim and the bully, Dr. Ryan said. Although it is widely thought to become less prevalent with age, 20%-30% of 8th through 12th graders have reported frequent involvement in bullying as a victim, bully, or both. A 2001 study from the National Institute for Child Health and Human Development found that nearly 30% of a representative sample of 15,686 6th through 10th graders reported moderate or frequent involvement in bullying: 13% as bullies, 10.6% as victims, and 6.3% as both, with boys more frequently being both the bully and the bullied (JAMA 2001;285:2094-100).

In the Pittsburgh Youth Study, a prospective cohort study of 503 boys followed from ages 6 through 19, being a bully at age 10 was the strongest predictor of delinquency. The study showed that 32.6% of bullies become delinquents, compared with 22.5% of nonbullies. In addition, being a victim at age 19 was the strongest predictor of depression, with 32% of victims having depression, compared with 22.7% of nonvictims, Dr. Ryan said (J. Aggress. Confl. Peace Res. 2011 June 9 [10.1108/17596591111132882]).

A recent meta-analysis from investigators at the University of Cambridge (England), found that the probability of being depressed up to 36 years later was much higher among people who had been bullied at school, compared with nonvictims. The authors also found that the probability of offending up to 11 years later was much higher for school bullies than noninvolved students, she noted (Crim. Behav. Ment. Health 2011;21:80-9).