Associations of bullying victimisation in different frequencies and types with suicidal behaviours among school-going adolescents in low- and middle-income countries

AIMS: Adolescent suicide is a severe public health problem in low- and middle-income countries (LMICs), and adolescents who are victims of bullying have a higher risk of suicidal behaviours. However, detailed global data concerning the association between bullying victimisation and suicide are lacking; thus, further multicontinental studies exploring the association of bullying victimisation at different frequencies and types with suicidal behaviours are urgent. METHODS: The data were extracted from the Global School-based Student Health Survey (GSHS) (2010–2017) conducted in 40 LMICs (n = 151 184, mean age: 14.77 years, s.d.: 1.59, 54.2% females). Data concerning past-30-day bullying victimisation, past 12-month suicidal behaviours (suicidal ideation, suicidal plans and suicidal attempts) and other adverse health behaviours or outcomes were collected. Chi-square tests were used to explore the correlations among the main variables. A multivariable logistic regression and stratified logistic regressions were conducted to assess the associations. RESULTS: The overall prevalence of bullying victimisation, suicidal ideation, suicidal plans and suicidal attempts were 28.72, 12.64, 11.84 and 10.79%, respectively. The results showed a positive association of different frequencies and types of bullying victimisation with suicidal behaviours: suicidal ideation (odds ratio (OR) = 2.43, 2.06–2.87), suicidal plans (OR = 2.69, 2.28–3.17) and suicidal attempts (OR = 3.23, 2.73–3.82). Adolescents also reported the effects of being made fun of because of their religion: suicidal ideation (OR = 1.63, 1.41–1.88), suicidal plans (OR = 1.44, 1.24–1.66) and suicidal attempts (OR = 1.73, 1.50–1.98). Moreover, these associations varied among teenagers of different gender and body mass indexes (BMIs) and were stronger among males and adolescents who were underweight, overweight or obese. CONCLUSIONS: Different types of bullying victimisation were positively related to suicidal behaviours; these associations varied among adolescents by gender and BMI. This study offers a theoretical basis for the identification of adolescents at a high risk of suicide and is beneficial for informing effective psychological interventions for constructing sound school environments, improving adolescents’ mental health and reducing the risk of suicide to promote health in LMICs and globally.