By Steven Reinberg

HealthDay Reporter

WEDNESDAY, Feb. 20 (HealthDay News) -- Children who are bullied often carry the scars of their experience into adulthood and suffer from anxiety, depression and suicidal thoughts, a new study indicates.

Even bullies themselves are at risk for psychological problems when they grow up, the researchers added. And children who have been both perpetrator and victim suffer the worst as adults.

"There has been a lot of research into how bullying affects children short-term. We followed kids into their early 20s to see if there was any kind of lasting effects of having been bullied," said study author William Copeland, an assistant clinical professor in the department of psychiatry and behavioral sciences at Duke University in Durham, N.C.

"We found kids that had been just bullied in childhood seemed to be at an elevated risk for a number of different anxiety disorders when they were adults," he said. "Kids that had been bullied and also bullied other kids seemed to be in the worst lot. They had thoughts of depression and hurting themselves when they were adults. They have the worst long-term outcomes."

Copeland believes the solution is clear.

"If we could set up a culture in schools where this isn't allowed to happen, then, I think, there are a lot of these problems we can avoid," he said.

The report was published Feb. 20 in the online edition of JAMA Psychiatry.

To see the long-term effects of bullying, Copeland's team collected data on more than 1,400 children who took part in the Great Smoky Mountain Study.

At the start of that study, these North Carolina kids were 9, 11 and 13 years old. The children and their parents were interviewed every year until the children were 16 and then periodically after that.

Each time the children were interviewed, they were asked whether they had been bullied or teased or whether they had bullied other children.

In all, 26 percent of the children said they had been bullied and 9.5 percent said they had bullied others or were both bullies and victims, the researchers found.

Years later, when those in the study were young adults, the researchers interviewed more than 1,200 of them to ask about their psychological health.

They found that both those who had been bullied as kids and those who had been both bullies and bullied had a higher risk for psychological problems than those who weren't bullied.

Those problems included depressive disorders, anxiety disorders, generalized anxiety, panic disorder and agoraphobia, which is anxiety about feeling trapped in a place.

Those who were both bullies and victims of bullying had, in addition to being at risk for anxiety and depression, the highest levels of suicidal thoughts.

Bullies were also at risk for antisocial personality disorder, which the U.S. National Library of Medicine defines as an ongoing pattern of "manipulating, exploiting or violating the rights of others."

To be sure their findings were confined to bullying, the researchers accounted for other factors such as poverty, abuse and an unstable or dysfunctional home life, which might have contributed to psychological problems.

One expert said that in many cases bullies and their victims have preexisting mental health problems that continue into adulthood.

"That shouldn't shock us, because most mental health problems have their beginning in adolescence or childhood," said Dr. Victor Fornari, director of the division of child/adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y.

"That's all the more reason why early intervention is important, to try to change the course of the difficulties," he said.

Ignoring the problem is not the way to go, Fornari said, and parents need to take these problems seriously.

"Parents who become aware that their child is either a bully or a victim of bullying should seek mental health care, because many of these young people will have disorders that would benefit from treatment," he said.

More information

For more on bullying, visit the American Psychological Association.