Effects of bullying and perceived social support on anxiety among adolescents with Major Depressive Disorder

Depression often co-occurs with various psychiatric disorders, including anxiety disorders. This study aimed to investigate the potential association between bullying experiences in adolescents diagnosed with Major Depressive Disorder (MDD) and the prevalence of anxiety. Additionally, the research explored whether perceived social support could mitigate this connection. A total of 2,343 adolescents with MDD were recruited from fourteen hospitals in China for this cross-sectional, multi-center study. The analysis involved multiple logistic regression models to assess the impact of bullying on anxiety and the potential moderating effects of different sources of social support. The prevalence of bullying among adolescents with MDD varied across different levels of anxiety, with an increasing incidence of bullying corresponding to higher levels of anxiety. When compared to individuals with low levels of social support, adolescents with MDD who received substantial support from both friends and family were 61% less likely to experience anxiety. Receiving moderate levels of support from friends was associated with a reduced likelihood of severe anxiety, approximately by 35%. Similarly, obtaining medium levels of family support led to a substantial reduction in the likelihood of experiencing moderate and severe anxiety to 0.51 and 0.46 times the original likelihood. Notably, perceived social support was found to reduce the probability of moderate and severe anxiety among adolescents with MDD who experienced bullying by 31% and 34%, compared to those without perceived support. Moderate family support was associated with lower chances of experiencing moderate and severe anxiety. Moreover, perceived social support was shown to effectively mitigate the adverse impact of bullying on anxiety.