Association of bullying victimization with suicidal ideation and suicide attempt among school students: A school-based study in Zhejiang Province, China

Background Evidence of associations between type-specific bullying victimization and suicidal ideation and suicide attempt among adolescents is scant. This study examined these associations among middle and high school students in China. Methods A cross-sectional study of 27,030 students with mean age of 15.7 ± 1.7 years, including 13,946 boys and 13,084 girls, was carried out between April and June 2022. Results The prevalence of suicidal ideation and attempt was 19.7 % and 2.9 %, respectively. 30.0 % (95%CI: 28.8–31.1) of students reported being bullied (i.e., bullying victimization) in the past 30 days, and the corresponding figs. (95%CI) for verbal bullying, relational bullying, property-related bullying, physical bullying, and cyberbullying were 11.0 % (10.4–11.7), 2.8 % (2.5–3.0), 1.9 % (1.7–2.2), and 5.7 % (5.3–6.0), respectively. After adjustment for socio-demographic status, lifestyle factors, academic performance, self-reported health and mental health, compared to those who reported not being bullied in the past 30 days, the odds ratios (95%CI) for suicidal ideation and suicide attempt among students who reported being bullied were 1.75 (1.60–1.90) and 2.01 (1.63–2.52), respectively. The corresponding odds ratios (95%CI) for verbal bullying were 1.77 (1.61–1.93) and 2.09 (1.67–2.61), respectively, for relational bullying were 1.77 (1.57–2.00) and 2.31 (1.79–2.98), respectively, for property-related bullying were 1.88 (1.48–2.37) and 2.44 (1.60–3.70), respectively, for physical bullying were 1.79 (1.30–2.47) and 2.86 (1.67–4.90), respectively, and for cyberbullying were 2.02 (1.71–2.39) and 2.83 (2.08–3.84), respectively. Conclusion All types of bullying victimization are strongly associated with both suicidal ideation and suicide attempt among middle and high school students.