Intended for healthcare professionals


Bullying, depression, and suicidal ideation in Finnish adolescents: school survey

BMJ 1999; 319 doi: (Published 07 August 1999) Cite this as: BMJ 1999;319:348
  1. Riittakerttu Kaltiala-Heino, senior assistant professor (merihe{at},
  2. Matti Rimpelä, professorb,
  3. Mauri Marttunen, senior researcherc,
  4. Arja Rimpelä, professora,
  5. Päivi Rantanen, professord
  1. a University of Tampere, Tampere School of Public Health, Box 607, 33101 Tampere, Finland
  2. b National Research and Development Centre for Welfare and Health, Box 220, 00531 Helsinki, Finland
  3. c Department of Mental Health and Alcohol Research, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki
  4. d Tampere University Hospital, Department of Adolescent Psychiatry, Box 2000, 33521 Tampere
  1. Correspondence to: R Kaltiala-Heino
  • Accepted 10 June 1999


Objective: To assess the relation between being bullied or being a bully at school, depression, and severe suicidal ideation.

Design: A school based survey of health, health behaviour, and behaviour in school which included questions about bullying and the Beck depression inventory, which includes items asking about suicidal ideation.

Setting: Secondary schools in two regions of Finland.

Participants: 16410 adolescents aged 14-16.

Results: There was an increased prevalence of depression and severe suicidal ideation among both those who were bullied and those who were bullies. Depression was equally likely to occur among those who were bullied and those who were bullies. It was most common among those students who were both bullied by others and who were also bullies themselves. When symptoms of depression were controlled for, suicidal ideation occurred most often among adolescents who were bullies.

Conclusion: Adolescents who are being bullied and those who are bullies are at an increased risk of depression and suicide. The need for psychiatric intervention should be considered not only for victims of bullying but also for bullies.

Key messages

  • About 1 in 10 schoolchildren report being bullied weekly at school

  • Adolescents who are bullied or who are bullies have an increased risk of depression and suicidal ideation

  • Bullies are often as depressed as those who are bullied, and suicidal ideation is even more common among bullies

  • Interventions aimed at reducing bullying in schools, as well as psychiatric assessment and treatment of bullies and those who are bullied, might also prevent depression and suicidal ideation


  • Funding None.

  • Competing interests None declared.

  • Accepted 10 June 1999
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