Children with type 1 diabetes (search) and other hormonal disorders (search) are often bullied by other kids. And this bullying could lead kids to adopt unhealthy behaviors, a researcher says.

"If you know kids may tease you because you have to go to the bathroom to check your blood sugar or you can't eat some foods, you might begin avoiding those things," Eric Storch, PhD, assistant professor of psychiatry and pediatrics at University of Florida's College of Medicine, says in a news release. "The idea behind it starts with social fears."

Storch and colleagues studied almost 100 children with various hormonal disorders including type 1 diabetes, thyroid problems, short stature, male breast development, and early or delayed puberty.

The endocrine system oversees the production of hormones, which affect the entire body. Some endocrine problems are obvious, like short stature. Others aren’t immediately visible. For instance, someone couldn’t spot a child with type 1 diabetes unless they saw them checking their blood sugar, injecting insulin, or wearing an insulin pump.

The kids studied were about 13 years old on average. During outpatient visits to the University of Florida’s pediatric endocrinology clinic, they completed written surveys about bullying, depression, social anxiety, and loneliness. Their parents also filled out questionnaires about their children’s self-esteem and behavior.

Nearly a third of the kids said they had been bullied in the last month. For many, bullying was accompanied by hurtful psychological experiences. Almost 20 percent said they feared social situations, nearly 8 percent showed signs of depression, and about 6 percent said they were lonely.

Their parents also noticed problems. Thirteen percent of parents and guardians noted signs of poor self-esteem in their kids, and 9 percent said the children misbehaved significantly.

"One of the things I often hear is, 'Everyone goes through this, why make a big deal of it?' I don't argue that this happens," Storch says. "The point is if it's chronic bullying, it's often distressing."

Which comes first: bullying or mental and emotional problems? It’s hard to say. Certainly, bullying is a well-known hazard for all kids, regardless of health status. But the stress of having a chronic medical condition might make some children with endocrine problems more vulnerable to bullies.

Of course, bullies don’t limit themselves to kids with endocrine problems. It’s estimated that a fifth of all children are regularly exposed to bullying, say the researchers. Sometimes, the torment is physical — hitting, pushing, threatening, or insulting. Bullying can also be relational, such as ignoring, shunning, or spreading rumors.

Some children in the study suffered less than others.

Those with obvious symptoms — such as male breast development, early or late puberty, or short stature — had an easier time handling bullying. Their peers and teachers might protect and help them, say the researchers. Or other psychological factors may be at work.

The fallout of bullying and related problems can be intense. By avoiding their peers out of fear, kids could miss important educational and social experiences. Others might skip their medications to blend in with the crowd, which could have dangerous health consequences.

Parents, teachers, and health care professionals should take bullying seriously and learn how to help kids cope, say the researchers. Their study appears in the December issue of The Journal of Pediatrics.

By Miranda Hitti, reviewed by Michael W. Smith, MD

SOURCES: Storch, E., The Journal of Pediatrics, December 2004; vol 145: pp 784-789. News release, University of Florida.