Emotional and Behavioural Problems in Children With Functional Gastrointestinal Disorders

Functional gastrointestinal disorders (FGIDs) are common in childhood, but psychological correlates remain poorly understood. We compared emotional and behavioural functioning in children with FGIDs with somatic and healthy controls.

Parents of children aged 2-12 years were recruited at the University Children's Hospital Basel (February 2024-February 2025). Children meeting Rome IV criteria formed the Functional Group; those with somatic gastrointestinal diseases and healthy peers served as Somatic and Healthy Controls. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and Patient Health Questionnaire (PHQ-4). Group differences were tested using non-parametric models and adjusted negative binomial regression.

Data from 218 children were analysed (Functional n = 66, Somatic n = 62, Healthy n = 90). SDQ total difficulties were markedly higher in FGIDs than in both control groups (p < 0.001). Differences were most pronounced for emotional and hyperactivity problems. Using age-adjusted SDQ total difficulties cut-offs, elevated scores occurred in 45.5% of children with FGIDs, compared with 8.1% in somatic and 10.0% in healthy peers. Parental psychological distress and separation predicted higher difficulties.

Emotional and behavioural difficulties in FGIDs exceed those observed in somatic gastrointestinal diseases, indicating a particularly high psychosocial burden. These findings highlight the relevance of psychological aspects within integrated paediatric gastroenterology care.