Abstract
BACKGROUND: Individuals with serious mental disorders (SMDs) are frequently exposed to bullying, which can severely affect their well-being. However, research on this issue remains limited in the Chinese context. OBJECTIVE: This study aimed to examine the prevalence and associated factors of bullying experienced by individuals with SMDs in China, with the goal of providing evidence that may inform strategies to improve their quality of life. METHODS: A multistage stratified random sampling method was used to survey 486 community patients with SMDs in Shandong province, China. Participants self-reported experiences of bullying. The Stigma Scale for Chronic Illnesses, 8-item version was used to measure self-stigma; the Pittsburgh Sleep Quality Index assessed sleep quality; and the Family Apgar Scale evaluated family functioning. Single-factor analysis, logistic regression, and negative binomial regression were used to analyze the associations between variables. RESULTS: The prevalence rate of bullying experienced by individuals with SMDs was 42.4% (206/486). Higher levels of self-stigma were significantly associated with increased odds of being bullied (odds ratio [OR] 1.041, 95% CI 1.017-1.065; P<.001), while better family functioning was associated with lower odds of experiencing bullying (OR 0.913, 95% CI 0.850-0.980; P=.01). Verbal abuse was associated with poorer sleep quality (OR 1.056, 95% CI 1.004-1.111; P=.04), particularly when reported as perpetrated by caregivers (OR 1.068, 95% CI 1.029-1.108; P<.001). In addition, age (P<.001), education level (P=.02), only-child status (P=.04), and diagnosis type (P=.03) were significantly related to bullying experiences. CONCLUSIONS: Higher levels of self-stigma were associated with experiencing bullying among individuals with SMDs, whereas better family functioning was associated with lower odds of being bullied. Verbal abuse-especially by caregivers-was associated with poorer sleep quality. These findings suggest that reducing self-stigma and strengthening family support may help improve quality of life for individuals with SMDs.