Investigating the Gut-Brain Axis in Adolescents With Mood Disorders and Functional Gastrointestinal Symptoms

This study aimed to estimate the proportion meeting Rome III criteria for functional gastrointestinal disorders (FGIDs) and examine associations with suicide ideation (Beck Scale for Suicide Ideation, BSS), depression (Center for Epidemiological Studies-Depression Scale for Children, CES-DC), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and perceived stress (Perceived Stress Scale, PSS) in child and adolescent psychiatric outpatients, including subgroup analyses by irritable bowel syndrome (IBS), functional constipation (FC), and subtype complexity (single vs. multiple).

We recruited 137 outpatients aged 12-18 years (2021-2023). FGIDs were classified with the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-Rome III). BSS, CES-DC, SCARED, and PSS assessed psychosocial burden. Group differences used standard comparisons (two-sided p<0.05).

Overall, 69.3% met Rome III criteria for ≥1 FGID subtype. Compared with the non-FGID group, the FGID group had higher scores on BSS (p=0.048), CES-DC (p=0.035), SCARED (p<0.001), and PSS (p=0.003). In three-group comparisons (non/single/multiple), CES-DC, SCARED, and PSS differed significantly, with single and multiple FGID groups exceeding non-FGID. In subgroup analyses, IBS-related groups showed higher anxiety and stress than non-FGID, whereas the single FC subtype did not differ significantly.

Among child and adolescent psychiatric outpatients, the proportion meeting the Rome III criteria for FGIDs was high and was significantly associated with psychological burden. These findings support integrating gastrointestinal symptom screening with mental health assessments at intake, with risk-stratified management for IBS-related presentations.