teen boy being bullied at school

Research links bullying has been linked with a wide range of medical, behavioral, and social problems, including psychosis. A January 2024 study in the journal Molecular Psychiatry suggests that young people who are bullied may have an increased likelihood of psychosis later in life.

This study, conducted by a team from the University of Tokyo, employed advanced imaging technology to identify changes in the brains of adolescents with history of being bullied. These changes, the team believes, could contribute to an elevated risk of psychotic symptoms.

The Scope of the Problem

Before we delve into the link between bullying and psychosis, let’s take a moment to discuss the prevalence of bullying and review what we mean when we talk about psychosis. We’ll begin with bullying.

Bullying is common in high schools throughout the United States.

StopBullying.gov, managed by the U.S. Department of Health and Human Services (DHHS), provides the following statistics about the scope of bullying among U.S. high school students:

  • 19% of U.S. high school students report being bullied on school grounds at least once in the previous 12 months.
  • Fewer than half (46%) of high school students said they notified a teacher or another adult at school about the incident.
  • About 15% of high school students report being bullied on social media apps or via text messages.

There are currently about 17 million students enrolled in public and private high schools in the U.S. According to the statistics above, this means that about 3.2 million students experienced in-school bullying in the past year, while about 2.5 million students experienced online bullying.

What is Psychosis?

Psychosis refers to an impaired ability to accurately perceive surroundings and communicate with others. Someone having a psychotic episode may show the following symptoms:


These involve perceiving things that do not exist. Seeing or hearing things (auditory and visual hallucinations) are the most common, but people can also develop gustatory (taste), olfactory (smell), and tactile (touch) hallucinations.


These are rigidly held beliefs that have no basis in reality, or that can be easily disproved. Examples include thinking that you have magical powers, believing that someone is sending you coded messages via mass media, or becoming convinced that you are being spied on or persecuted.

Disorganized speech:

Examples of this symptom include jumping from topic to topic with no logical progression, using words due to their sound rather than their meaning, responding to questions with unrelated comments, and speaking in an incomprehensible manner.

Grossly disorganized behaviors:

Behaviors that fall into this category include acting in a manner that appears bizarre to others, having difficulty with goal-directed behaviors such as self-care and basic activities of daily living, and expressing unpredictable agitation.

Negative symptoms:

Examples of negative symptoms can include speaking in a monotone, absence of facial expression, finding it difficult or impossible to experience joy, and exhibiting little to no interest in interacting with others.

Hallucinations, delusions, and disordered speech are the most common symptoms of psychosis. To receive a diagnosis for schizophrenia or schizoaffective disorder, a person must experience at least one of those three symptom types, as well as any other symptom from the list above.

Risk factors for psychosis include certain mental illnesses, neurological disorders such as Alzheimer’s disease, brain injuries, medical issues such as brain tumors and syphilis, substance misuse, and sleep deprivation. As we discuss below, bullying may also increase risk for psychosis.

Bullying, Brain Changes, and Psychosis

Researchers suggest the link between being bullied and psychotic episodes involves a brain chemical called glutamate.

Glutamate is an excitatory neurotransmitter. It prompts neurons to pass information through the central nervous system (CNS). Virtually every cell in the CNS has a glutamate receptor.

Research into glutamate suggests that it plays an important role in functions such as cognition and mood regulation. Researchers theorize glutamate abnormalities contribute to some mental health disorders, including major depressive disorder, bipolar disorder, and schizophrenia.

In the case of schizophrenia, glutamate levels in the anterior cingulate cortex (ACC) of the brain appear particularly significant.

So, how does this relate to bullying victims?

The University of Tokyo study cited at the beginning of this article used magnetic resonance spectroscopy (MRS) to assess ACC glutamate levels in the brains of Japanese teens.

About the Study:

  • Participants were 237 adolescents (128 male and 109 female, with an average age of about 13.5) who resided in the Tokyo metropolitan area.
  • Researchers excluded participants diagnosed with schizophrenia or who had an “evident psychiatric or neurological disorder.”
  • The participants completed two MRS sessions. The average time between each assessments was two years.
  • The researchers used questions from the Diagnostic Interview Schedule for Children (DISC-C) to evaluate subclinical psychotic episodes.
  • Questionnaires determined which students experienced bullying and which ones had no history of bullying-related victimization.
  • The researchers also identified which of the bullied participants sought help in the aftermath of the experience and which did not.

According to a Feb. 29, 2024, Asian Scientist article, an analysis of this data revealed “a significant association between bullying and higher levels of subclinical psychotic experiences in early adolescence.”

A subclinical psychotic experience is one that includes one or more of the symptoms listed above, but did not meet the full criteria for clinical diagnosis.

Specific findings, as reported in the study, include:

  • Bullied participants had lower glutamate levels in their anterior cingulate cortex than those who weren’t bullied.
  • Bullied students who sought help in the aftermath of the event or events had increased ACC glutamate levels compared to bullied students who didn’t get help.
  • Reduced glutamate levels correlated with increased risk of subclinical psychotic episodes across both MRS sessions.
  • Participants with lower glutamate levels during their first MRS sessions were more likely to experience subclinical psychotic experiences during their second session.

“Studying these subclinical psychotic experiences is important for us to understand the early stages of psychotic disorders and for identifying individuals who may be at increased risk for developing a clinical psychotic illness later on,” Naohiro Okada, MD, PhD, who was the study’s lead author, said in the Asian Scientist article.

Other Mental Health Effects of Bullying

The establishment of a potential link between bullying and psychosis is a relatively recent development. But the understanding that bullying impacts mental health is not new.

A March 2021 article reports on several studies that show bullying can lead to the following problems:

  • Feelings of rejection, exclusion, and isolation
  • Diminished self-esteem
  • Poor self-image
  • Acute stress disorder (ASD)
  • Posttraumatic stress disorder (PTSD)

The same article noted that people who experience bullying may be at increased risk for the following behaviors later in life:

  • Diminished performance in school or at work
  • Substandard social functioning
  • Interpersonal violence
  • Anger management concerns
  • Diminished capacity to trust
  • Difficulties in relationships
  • Substance abuse

While discussions of the mental health impact of bullying typically focus on the victims, it’s important to note that bullies themselves are at increased risk of current and future problems. For example:

  • A 2009 meta-analysis found that adolescent bullies have a “significantly higher risk” of psychosomatic problems later in life, compared to people who never bullied anyone.
  • A 2014 longitudinal cohort study involving more than 4,700 participants found that elementary school students who bully others may be at increased risk of psychotic disorders later in life.
  • A 2015 study found that adolescent bullies aged 14-15 had higher rates of mental health problems at age 27 than individuals who neither bullied nor were victims of bullying.

Preventive Strategies

In the Asian Scientist article we mention above, researcher Naohiro Okada called for continued efforts to prevent bullying and help young people who experience bullying.

“Anti-bullying programs in schools that focus on promoting positive social interactions and reducing aggressive behaviors are essential for their own sake and to reduce the risk of psychosis and its subclinical precursors,” Okada said. “These programs can help create a safe and supportive environment for all students, reducing the likelihood of bullying and its negative consequences.”

Though the statistics we referred to above indicate considerable work remains in this area, many organizations work to make schools safer places for students:

  • StopBullying.gov has age-appropriate bullying prevention information for children, teenagers, and adults.
  • The U.S. Centers for Disease Control and Prevention (CDC) dedicated a page on its website to bullying information and prevention tips.
  • The non-profit Coalition for Children created the Take A Stand bullying prevention program.

Find Treatment for Psychosis

If someone in your life experiences psychotic episodes, please know that help is available. Crownview Psychiatric Institute offers a dynamic array of personalized services to help adults with psychosis and other complex mental health challenges.

To learn more about our programming or to determine if our center is the ideal place for your loved one, please visit our Contact page or call us today.