Bullying Victimization and Suicide Attempt Among Adolescents Aged 12-15 Years From 48 Countries

Objective: Adolescent suicide is a global public health problem. Bullying is a risk factor for suicidality in adolescence; however, global data on its association with suicide attempts are lacking, and data from low- and middle-income countries and non-Western settings are scarce. Thus, this study assessed the association between bullying victimization and suicide attempts using data from 48 countries (predominantly low- and middle-income countries) across multiple continents. Method: Data from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and past 30-day bullying victimization were collected. Multivariable logistic regression and meta-analysis with random effects were conducted to assess the associations. Results: The final sample consisted of 134,229 adolescents 12 to 15 years of age. The overall prevalences of suicide attempts and bullying victimization were 10.7% and 30.4%, respectively. After adjustment for sex, age, and socioeconomic status, bullying victimization was significantly associated with higher odds for a suicide attempt in 47 of the 48 countries studied, with the pooled odds ratio being 3.06 (95% CI 2.73-3.43). A larger number of days bullied in the past month was dose-dependently associated with higher odds for suicide attempts. The past-year prevalence of suicide attempts ranged from 5.9% for the no bullying group up to 32.7% for the being bullied for 20 to 30 days/month group (odds ratio 5.51, 95% CI 4.56-6.65). Conclusion: Bullying victimization could be an important risk factor of suicide attempts among adolescents globally. Thus, there is an urgent need to implement effective and evidence-based interventions to address bullying to prevent suicides and suicide attempts among adolescents worldwide.