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Introduction: Bullying remains a major public health concern among adolescents and is associated with adverse mental health and behavioral outcomes. Evidence from low- and middle-income countries, including Ecuador, remains limited. Methods: We conducted a cross-sectional study using data from the Ecuadorian version of the Youth Risk Behavior Surveillance System (YRBSS). Associations between school bullying, cyberbullying, and emotional distress (sadness), suicidal behaviors (ideation, planning, attempts), and risk behaviors (alcohol use, marijuana use, and school fights) were assessed using chi-square tests and logistic regression. Odds ratios (OR) and relative risks (RR) with 95% confidence intervals (CI) were calculated. Results: Among 300 adolescents, 10.0.3% reported school bullying and 16.0% reported cyberbullying. Bullying victimization was associated with higher odds of sadness (OR 3.33, 95% CI 1.50-7.35), suicidal ideation (OR 431, 1.99-9.0.32), suicidal planning (OR 5.45, 2.51-1183), and suicide attempts (OR 5.43, 2.39-12.36). Cyberbullying was strongly associated with alcohol consumption (RR 5.33, 95% CI 2.47-11.46) and marijuana use (RR 7.20, 1.86-27.92). Discussion: Bullying and cyberbullying are strongly associated with emotional distress, suicidal behaviors, and substance use among adolescents in Ecuador. These findings underscore the urgent need for school-based prevention strategies and integrated public health interventions targeting adolescent mental health.
Fors et al. (Tue,) studied this question.