Psychological disorders associated with allergic diseases in children: a systematic review and meta-analysis

In children with allergies, psychological issues are becoming more frequent and complicated. To quantify the prevalence and allergens' link to childhood psychological disorders. PubMed, ScienceDirect, Cochrane Library, Google Scholar, and Scopus, were searched until December 2024 using suitable keywords. Studies encompassing children < 18 years diagnosed with allergic diseases and reported with any psychological disorders were selected. The pooled effect size was calculated using random effect models utilizing RevMan 5.4, which produced odds ratios (OR) with 95% CI, and Jamovi software assessed the prevalence of allergic illnesses with psychological disorders. Heterogeneity among studies was assessed using I² statistics, and methodological quality was assessed using the risk of bias for Non-Randomized Studies- Exposure (ROBINS-E). For publication bias, a funnel plot was constructed. The Grading for Recommendations Assessment, Development and Evaluation (GRADE) framework was used for the assessment of the certainty of the evidence. All 24 studies involving children with allergies and psychological disorders were included. A meta-analysis showed that the prevalence of psychological disorders among children with allergies was significantly (p < 0.01) higher. For asthma, it was 33% (95% CI: 22 to 44, I2 = 99.46%), allergic rhinitis 47% (95% CI: 30 to 64, I2 = 98), atopic dermatitis 14% (95% CI: -0.00 to 29, I2 = 99.74%, food allergy 17% (95% CI: 0.03-0.31, I2 = 99.74%), and combined allergies 57% (95% CI: 0.23-0.90, I2 = 99.98%). While eczema had a non-significant (p > 0.01) prevalence with psychological disorders at 20% (95% CI: 0.15-0.24, I2 = 0%). Furthermore, the pooled OR was 6 (95% CI, 3.69-9.74, I2 = 93%), indicating that allergic illnesses considerably (p < 0.01) enhanced psychological disorder risk. Meta-regression indicated a non-significant association of covariates with source of heterogeneity. Egger's test indicated a potential source of publication bias. Children with allergies are at higher risk of developing psychological disorders. It emphasizes the need for integrated care to address physical and mental health problems.