The objective was to study the prospective link between involvement in bullying (bully, victim, bully/victim) and subsequent suicide ideation in preadolescent children in the United Kingdom.

6043 children in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort were assessed between 4 and 11 years to ascertain involvement in bullying and suicide ideation at 11 (11.7) years.

Victimization was significantly associated with suicide ideation after adjusting for confounders: child report at 8 and 10 years (Odds Ratio [O.R] = 1.78; Confidence Interval [C.I] = 1.28 to 2.49) and (O.R = 2.09; C.I = 1.5 to 2.90); mother report (O.R = 2.27; C.I = 1.62 to 3.18); teacher report (O.R = 2.02; C.I = 1.25 to 3.25). Bully/victims were at highest risk for suicide related behavior: child report at 8 years (O.R = 2.88; C.I = 1.74 to 4.76); child report at 10 years (O.R = 4.29; 2.72 to 6.75); mother report (O.R = 3.54; C.I = 2.27 to 5.54); teacher report (O.R = 2.70, C.I = 1.46 to 4.99). Pure bullies had no increased risk of suicide ideation.

Being a target of bullying, especially as a bully/victim, significantly increases the risk of suicide ideation in preadolescent children. Prevention programs should begin in elementary school and clinicians should routinely enquire about peer relationships.