Being bullied as a child is worse for a person's mental health than suffering abuse or neglect, scientists claim.
Children who are tormented at school are almost five times more likely to suffer anxiety and nearly twice as likely to have depression or self-harm at 18 than those who are maltreated, a study found.
Young people who are both maltreated and bullied have an increased risk of mental health problems, but the risk was not higher than those who are only bullied, scientists said.
And being abused or neglected, but not bullied, was not linked with any increased risk of psychological problems, they claim.
Professor Dieter Wolke, a psychologist at Warwick University, said: 'Since one-in-three children worldwide report being bullied, and it's clear bullied children have similar or worse mental health problems later in life to those who are maltreated, more needs to be done to address this imbalance.
'Until now governments have focused their efforts and resources on family maltreatment rather than bullying.
'Moreover it's vital schools, health services and other agencies work together to tackle bullying.'
The study of about 5,500 children, published in The Lancet Psychiatry, is the first to directly compare the effects of maltreatment by adults and bullying by peers on mental health outcomes, including anxiety, depression, self-harm and suicidal tendencies.
Bullying, sexual pressure and the 24-hour online lifestyle is increasing the risk of schoolgirls developing emotional problems, experts have warned.
Girls aged 11 to 13 are more at risk of suffering emotional torment, than they were five years ago.
A new study found the number at risk rose from 13 to 20 per cent from 2009 to 2014.
Researchers at University College London said in a mixed classroom of 30 pupils, it was likely around three girls would be battling emotional problems, last year.
That compares with one or two girls in the same sized class in 2009.
Sarah Brennan, chief executive of the charity YoungMinds branded the research, 'shocking further, concrete evidence' of the worsening state of children's mental health.
'Young people tell us that they feel enormous pressures today, ranging from bullying, the 24/7 online environment and sexual pressures to issues around body image, school stress and family breakdown,' she said.
It analysed 4,026 youngsters from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) whose parents provided information on maltreatment between the ages of 8 weeks and 8.6 years and their child's reports of bullying when they were eight, ten and 13.
It also studied 1,420 children from the Great Smoky Mountain Studies (GSMS) in the US who reported information on maltreatment and bullying between the ages of 9 and 16.
Professor Wolke, who is presenting his research at a Paediatric Academic Societies conference in San Diego, said: 'This is to our knowledge the first study to compare the long-term mental health outcomes of child maltreatment by adults with being bullied by peers.
'The results are consistent across the two cohorts (ALSPAC and GSMS) showing children who were bullied by peers only were more likely to have overall mental health problems, anxiety, depression and self-harm or have considered suicide than those who were neither bullied nor maltreated.
'Children who were both maltreated and bullied were also at increased risk for mental health problems but the effects were not higher than those of being bullied alone.
'By contrast our results did not show any increased risk of mental health problems for children that were maltreated, but not bullied, in the UK, but showed an increased risk of depression according to the US cohort.
'Being bullied by peers had worse long-term adverse effects on young adults' mental health than being maltreated by adults.
'Both current results and previous literature show the negative effect of school bullying.
'The insufficiency of resources for bullying compared with those for family maltreatment requires attention.
'It is important for schools, health services and other agencies to coordinate their responses to bullying and research is needed to assess policies and processes that work across these agencies.
'Future studies of maltreatment should take into account the effects of peer bullying.'
The harmful effects of bullying remained even when other factors known to increase the risk of child abuse and bullying - including family hardship and the mental health of mothers - were taken into account.
Dr David Finkelhor and Dr Corinna Jenkins Tucker, of New Hampshire University, who reviewed the study for the journal, said: 'This new study illustrates the growing consensus children are entitled to grow up free from violence, denigration and non-consented sexual activity at the hands of both adults and young peers.
'That growing consensus might be responsible for the fact that - if the epidemiological data are to be trusted - in spite of the fragmentations of response systems the toll of some of these various scourges seems to be on the decline in the past 20 years.'
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