From trauma to treatment: A scoping review of childhood bullying and its role in psychotic disorders

Introduction: Childhood adversities are well-established risk factors for the later development of severe mental illness, and experiences of bullying are frequently reported among individuals with psychotic disorders. Bullying may influence symptom presentation, illness trajectory, and treatment responsiveness. It has been hypothesized that patients with psychosis and trauma could benefit from psychotherapeutic interventions. This scoping review aims to synthesize existing literature on the association between childhood bullying and psychotic disorders, including implications for treatment. Methods: A systematic search was conducted in PubMed and Embase on June 24, 2025, using the terms “bullying” AND “schizophrenia” OR “psychoses.” After removing duplicates, 324 records were screened independently by two reviewers. A total of 42 full-text articles and 4 abstracts met the inclusion criteria and were included in the synthesis. Results: Evidence consistently indicates that childhood bullying increases the risk of developing psychosis, particularly when combined with other adversities or genetic vulnerability. While biological and psychological pathways—such as HPA axis dysregulation and maladaptive cognitive schemas—have been proposed, empirical support remains limited. Bullying has been associated with more severe paranoid ideation, persistent delusions, more abnormal self-experiences and poorer social cognitive functioning. Patients with bullying histories may also exhibit reduced responsiveness to antipsychotic medication. No studies directly examined the efficacy of psychotherapy in this population, though its potential value is widely acknowledged. Conclusions: Despite consistent evidence linking childhood bullying to psychotic disorders, optimal treatment strategies remain unclear. Future research should prioritize evaluating potential mechanisms and targeted interventions to inform more effective, individualized treatment approaches.