Background

Bullying is a common form of violence among children and adolescents. Young people with neurodevelopmental or psychiatric conditions might have an increased risk of bullying victimisation and perpetration. We aimed to assess the odds of bullying involvement and its association with mental health measures in these populations.

Methods

In this systematic review and meta-analysis, we searched PubMed, ERIC, Psychology and Behavioural Sciences Collection, Web of Science Core Collection, PsycArticles, and PsycInfo databases from inception up to Aug 8, 2023, and included articles reporting data on bullying outcomes of current bullying (within the past year) among children and adolescents (aged 4–17 years) with a diagnosis of a neurodevelopmental or psychiatric condtion provided by a health professional. Bullying type was classified as traditional (physical, verbal, or relational) or as cyberbullying (intentional and repeated harm inflicted through electronic devices and social media), and bullying involvement was classified as victimisation, perpetration, and perpetration–victimisation. Mental health measures were collected and the associations with bullying involvement assessed. We used random-effects meta-analyses to estimate prevalence and odds ratios (ORs) for bullying involvement. Heterogeneity was assessed using the I² statistic, and publication bias was tested with Egger's regression. This study is registered with PROSPERO, CRD42021235043.

Findings

We included 212 studies in the meta-analysis. The total sample comprised 126 717 cases (mean age 12·34 years [SD 1·82], 37·6% girls) and 504 806 controls (12·5 years [SD 1·86], 47·6% girls). For traditional bullying, the pooled prevalence was 42·2% (95% CI 39·6–44·9) for victimisation, 24·4% (22·6–26·3) for perpetration, and 14·0% (11·4–17·1) for perpetration–victimisation. For cyberbullying, the prevalence was 21·8% (16·0–28·9) for victimisation, 19·6% (13·4–27·7) for perpetration, and 20·7% (8·4–42·6) for perpetration–victimisation. Compared with controls, young people with neurodevelopmental or psychiatric conditions were more likely to be involved in traditional and cyberbullying as a victim (OR 2·85 [95% CI 2·62–3·09] and 2·07 [1·63–2·61]), perpetrator (2·42 [2·20–2·66] and 1·91 [1·60–2·28]), and perpetrator–victim (3·66 [2·83–4·74] and 1·85 [1·05–3·28]). Bullying involvement was associated with higher scores in mental health measures in young people with neurodevelopmental or psychiatric conditions, particularly internalising symptoms and externalising symptoms.

Interpretation

Our study underscores bullying involvement as a prevalent risk factor in young people with neurodevelopmental or psychiatric conditions that might add to their disease burden through its negative effects on mental health. Interventions targeting these vulnerable populations are warranted to improve their mental health and their future social integration.

Funding

Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, and Consorcio Centro de Investigación Biomédica en Red.

中文翻译：

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患有神经发育和精神疾病的儿童和青少年的校园欺凌：系统评价和荟萃分析

背景

欺凌是儿童和青少年中常见的暴力形式。患有神经发育或精神疾病的年轻人遭受欺凌和实施欺凌的风险可能会增加。我们的目的是评估这些人群中参与欺凌的可能性及其与心理健康措施的关系。

方法

在这项系统综述和荟萃分析中，我们检索了 PubMed、ERIC、Psychology and Behavioral Sciences Collection、Web of Science Core Collection、PsycArticles 和 PsycInfo 数据库，从建库到 2023 年 8 月 8 日，并纳入了报告欺凌结果数据的文章。当前儿童和青少年（4-17 岁）中的欺凌行为（过去一年内），并由卫生专业人员诊断为神经发育或精神疾病。欺凌类型分为传统欺凌（身体欺凌、言语欺凌或关系欺凌）或网络欺凌（通过电子设备和社交媒体故意和反复造成伤害），欺凌行为分为受害、加害和加害-受害。收集了心理健康指标，并评估了与欺凌行为的关联。我们使用随机效应荟萃分析来估计欺凌行为的发生率和比值比 (OR)。使用I ^2统计量评估异质性，并使用 Egger 回归测试发表偏倚。本研究已在 PROSPERO 注册，CRD42021235043。

发现

我们在荟萃分析中纳入了 212 项研究。总样本包括 126 717 例病例（平均年龄 12·34 岁 [SD 1·82]，37·6% 女孩）和 504 806 名对照者（平均年龄 12·5 岁 [SD 1·86]，47·6% 女孩）。对于传统欺凌，受害的汇总患病率为 42·2% (95% CI 39·6–44·9)，施暴为 24·4% (22·6–26·3)，施暴为 14·0% (11 ·4–17·1) 犯罪-受害。对于网络欺凌，受害发生率为 21·8% (16·0–28·9)，施暴发生率为 19·6% (13·4–27·7)，施暴发生率为 20·7% (8·4–42·) 6) 实施犯罪——受害。与对照组相比，患有神经发育或精神疾病的年轻人更有可能作为受害者参与传统欺凌和网络欺凌（OR 2·85 [95% CI 2·62–3·09] 和 2·07 [1·63– 2·61]），犯罪者（2·42 [2·20–2·66]和1·91 [1·60–2·28]），以及犯罪者-受害者（3·66 [2·83–4· 74]和1·85 [1·05–3·28]）。患有神经发育或精神疾病的年轻人，尤其是内化症状和外化症状的年轻人，参与欺凌行为与心理健康测量得分较高有关。

解释

我们的研究强调，欺凌行为是患有神经发育或精神疾病的年轻人的一个普遍危险因素，这可能会通过对心理健康的负面影响增加他们的疾病负担。针对这些弱势群体的干预措施有必要改善他们的心理健康和未来的社会融合。

资金

Instituto de Salud Carlos III、西班牙科学与创新部和 Consorcio Centro de Investigación Biomédica en Red。