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World J Psychiatry. Aug 19, 2026; 16(8): 119686
Published online Aug 19, 2026. doi: 10.5498/wjp.119686
Published online Aug 19, 2026. doi: 10.5498/wjp.119686
Anxiety and depression in Rome IV disorders of gut–brain interaction: Prevalence, clinical impact, and temporal association
Manjeet Kumar Goyal, Department of Internal Medicine, Cleveland Clinic Akron General Hospital, Akron, OH 44308, United States
Omesh Goyal, Jaskirat Kaur, Gargi Prashar, Ajit Sood, Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Praneet Wander, Division of Gastroenterology, St Mary’s Hospital, Trinity Health Of New England, Waterbury, CT 06708, United States
Prerna Goyal, Department of Medicine, R.G. Stone Super Speciality Hospital, Ludhiana 141001, Punjab, India
Co-first authors: Manjeet Kumar Goyal and Omesh Goyal
Author contributions: Goyal MK and Goyal O provided equal contributions as detailed below, meriting co-first authorship; Goyal MK, Goyal O and Sood A conceptualized the study; Goyal MK, Goyal O and Goyal P designed the methodology; Wander P, Goyal P, and Prashar G performed literature search; Goyal O, Goyal MK, Kaur J and Prashar G contributed to patient enrollment; Goyal MK, Prashar G, Kaur J, and Goyal P performed the investigation and statistical analysis; Goyal MK, Wander P, Prashar G and Kaur J generated the visualization of data and writing of the original manuscript draft; All authors performed editing of the subsequent versions of the manuscript; Goyal O, Mehta V, and Sood A provided the study supervision and data validation; All authors read and approved the final version of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Dayanand Medical College and Hospital, Ludhiana, No. 2018-394.
Informed consent statement: Informed consent was obtained.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data technical appendix, statistical code, and dataset available from the corresponding author upon reasonable request.
Corresponding author: Omesh Goyal, Department of Gastroenterology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana 141001, Punjab, India.
Received: February 3, 2026
Revised: March 9, 2026
Accepted: April 8, 2026
Published online: August 19, 2026
Processing time: 165 Days and 21.7 Hours
Revised: March 9, 2026
Accepted: April 8, 2026
Published online: August 19, 2026
Processing time: 165 Days and 21.7 Hours
Core Tip
Core Tip: Psychological comorbidities are highly prevalent in disorders of gut-brain interaction (DGBIs), particularly among patients with overlapping syndromes. In this large Rome IV-based cohort, anxiety and depression affected nearly two-thirds and one-third of patients, respectively, with substantially worse quality of life in overlap DGBIs. Notably, gastrointestinal symptoms preceded the onset of anxiety and depression in most cases, supporting a predominant gut-to-brain trajectory. These findings emphasize the need for early identification and proactive management of DGBIs, alongside integrated gut-brain care strategies, to potentially mitigate subsequent psychological morbidity.