Mental Health Disorders in Pediatric Inflammatory Bowel Disease: Epidemiology, Mechanisms, and Interventions

This review aims to synthesize current evidence on the association between pediatric inflammatory bowel disease (IBD) and mental health disorders, with a focus on epidemiology, underlying pathophysiological mechanisms, and advances in screening and intervention strategies. Pediatric IBD is increasingly recognized as a condition with substantial psychological as well as gastrointestinal burden. Children and adolescents with IBD have a markedly higher prevalence of mental health disorders than the general population, most commonly depression, anxiety, and sleep disorders, with risk appearing particularly higher in adolescents and in those with Crohn's disease. Based on psychiatric evaluations, the prevalence of mental disorders in this population ranges from 42% to 73%. Accumulating evidence suggests a complex, bidirectional relationship between intestinal inflammation and mental health, mediated through interacting mechanisms that include gene-environment interactions, dysregulation of the gut-brain axis, immune imbalance, and medication-related effects. Although several validated screening tools for anxiety and depression have been introduced into clinical practice, mental health disorders in pediatric IBD remain frequently underrecognized and undertreated. Psychological interventions, family-centered care models, and pharmacologic treatments show potential benefit, but evidence in pediatric populations is limited and largely extrapolated from adult studies. Greater clinical awareness, routine mental health screening, and integrated multidisciplinary care interventions are essential to improve outcomes. Future large-scale, multi-center, and longitudinal studies are needed to clarify underlying mechanisms and optimize prevention and treatment strategies. Unlike previous reviews that often combine adult and pediatric populations, this review specifically focuses on pediatric-onset IBD and provides a dedicated synthesis of mental health comorbidities in children and adolescents.