Victims, bullies and bully–victims: prevalence and association with negative health outcomes from a cross-sectional study in São Paulo, Brazil

Objectives To estimate the prevalence of self-reported bullying as victims, bullies or bully–victims among 9th grade adolescents in the city of São Paulo, Brazil; to investigate association between bullying with negative health outcomes. Methods Cross-sectional data were obtained in 2017 from a sample of Brazilian adolescents ( n = 2680) using a structured, self-administered questionnaire. Bivariate and multivariate Poisson regression were employed to assess in which extent the experience of bullying in position of victim, bully or bully-victim affects adolescents' health. Results Prevalence of bullying victimization was 18.3%, while victimization/perpetration and perpetration corresponded to 10.42% and 4.9%, respectively. Adolescents who experienced bullying victimization were more likely to present high levels of internalizing symptoms, to report self-harm, to present negative self-rated health and to use tobacco, when compared with those not involved. Bullies were more likely to use alcohol and to binge drinking. bully–victims presented a higher prevalence of all health outcomes, except for tobacco use. Conclusions Our findings highlight the effect of bullying in adolescents’ health, regardless of the position. Planned intersectoral efforts between parents, health and education systems to prevent bullying could therefore reduce negative health outcomes during adolescence.