Anxiety and depression in Rome IV disorders of gut–brain interaction: Prevalence, clinical impact, and temporal association

doi:10.5498/wjp.119686

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World Journal of Psychiatry

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2220-3206

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Psychiatry. Aug 19, 2026; 16(8): 119686
Published online Aug 19, 2026. doi: 10.5498/wjp.119686

Table 1 Baseline characteristics of patients with disorders of gut-brain interaction and controls, n (%)

Characteristics	DGBI patients (n = 1044)	Controls (n = 1021)	P value
Age (years)
18-30	226 (21.6)	193 (18.9)	0.241
31-40	286 (27.4)	314 (30.8)
41-50	269 (25.8)	306 (29.9)
51-60	176 (16.9)	156 (15.3)
61-70	87 (8.3)	52 (5.1)
Gender
Male	542 (51.9)	619 (60.6)	0.742
Female	502 (48.1)	402 (39.4)	0.742
Body mass index (kg/m²)
Underweight (< 18.5)	18 (1.7)	6 (0.6)	0.549
Normal (18.5-24.9)	393 (37.6)	437 (42.8)
Overweight (25-29.9)	425 (40.7)	387 (37.9)
Obese (≥ 30)	208 (19.9)	191 (18.7)
Duration of symptoms
6 months to < 1 year	336 (32.2)	NA	NA
1 year to < 2 years	269 (25.8)	NA
2 to < 5 years	256 (24.5)	NA
≥ 5 years	183 (17.5)	NA
Comorbidities
Diabetes Mellitus	125 (11.9)	156 (15.3)	0.891
Hypertension	146 (14.0)	137 (13.4)	0.766
Thyroid disorders	35 (3.4)	42 (4.1)	0.714
Education
Uneducated	107 (10.2)	119 (11.7)	0.157
High school	412 (39.5)	376 (36.8)
Graduate	388 (37.2)	405 (39.7)
Postgraduate	137 (13.1)	121 (11.9)
Residence
Urban	409 (39.2)	398 (39)	0.892
Semi-urban	257 (24.6)	248 (24.3)
Rural	378 (36.2)	375 (36.7)

DGBI: Disorder of gut-brain interaction; NA: Not applicable.

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Table 2 Comparison of clinical characteristics of “disorders of gut-brain interaction” patient groups with and without anxiety

Characteristics	Anxiety present (n = 671)	Anxiety absent (n = 373)	P value
Age (years)	42.2 ± 12.8	41.2 ± 12.2	0.219
Female gender	376 (56.1%)	126 (33.8%)	0.0001
Body mass index (kg/m²)	23.1 ± 4.8	23.9 ± 4.1	0.0067
Duration of symptoms (years)	2.9 ± 3.9	2.3 ± 2.7	0.0084
Overlap DGBI present	342 (50.9%)	79 (21.2%)	0.0001
Depression present	361 (53.8%)	34 (9.1%)	0.0001
HRQoL Physical score	11.9 ± 2.5	17.3 ± 1.6	0.0001
HRQoL Mental score	11.4 ± 2.8	16.4 ± 1.3	0.0001

DGBI: Disorder of gut-brain interaction; HRQoL: Health-related quality of life.

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Table 3 Comparison of clinical characteristics of “disorders of gut-brain interaction” patient groups with and without depression

Characteristics	Depression present (n = 395)	Depression absent (n = 649)	P value
Age (years)	42.5 ± 12.4	41.4 ± 12.7	0.1712
Female gender	241 (61.1%)	261 (40.2%)	0.0001
Body mass index (kg/m²)	23.3 ± 4.5	23.7 ± 4.2	0.1467
Duration of symptoms (years)	3.3 ± 4.6	2.3 ± 2.9	0.0001
Overlap DGBI present	216 (54.7%)	205 (31.6%)	0.0001
Anxiety present	361 (91.4%)	310 (47.7%)	0.0001
HRQoL Physical score	11.6 ± 3.1	15.3 ± 2.8	0.0001
HRQoL Mental score	10.8 ± 3.2	14.7 ± 2.6	0.0001

DGBI: Disorder of gut-brain interaction; HRQoL: Health-related quality of life.

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Table 4 Prevalence of psychological comorbidities in various “disorders of gut-brain interaction” subgroups with stratification according to overlap status, n (%)

DGBI groups	Anxiety prevalence				Depression prevalence
DGBI groups	All patients	Patients with a single DGBI	Patients with overlapping DGBIs	P value (single vs overlapping DGBIs)	All patients	Patients with a single DGBI	Patients with overlapping DGBIs	P value (single vs overlapping DGBIs)
All DGBIs	671/1044 (64.2)	329/623 (52.8)	342/421 (81.2)	0.0001	395/1044 (37.8)	179/623 (28.7)	216/421 (51.3)	0.0001
Esophageal Disorders (n = 348)	248/348 (71.2)	79/143 (55.2)	169/205 (82.4)	0.0001	138/348 (39.6)	35/143 (24.5)	103/205 (50.2)	0.0001
Gastroduodenal disorders (n = 521)	362/521 (69.5)	85/177 (32.8)	8277/344 (80.5)	0.0001	227/521 (43.6)	49/177 (27.7)	178/344 (51.7)	0.0001
Bowel disorders (n = 415)	273/415 (65.8)	122/221 (55.2)	151/194 (78.4)	0.0001	173/415 (41.7)	72/221 (32.6)	101/194 (52.6)	0.0001
Centrally mediated disorders of gastrointestinal pain (n = 48)	36/48 (75)	15/24 (62.5)	21/24 (87.5)	0.0933	23/48 (47.9)	8/24 (33.3)	15/24 (62.5)	0.0820
Gall bladder and sphincter of Oddi disorders (n = 14)	10/14 (71.42)	7/11 (63.63)	3/3 (100)	0.5055	5/14 (35.7)	4/11 (36.4)	1/3 (33.3)	1
Anorectal disorders (n = 65)	39/65 (60)	20/46 (43.47)	19/19 (100)	0.0001	22/56 (39.28)	10/46 (21.73)	12/19 (63.15)	0.0012
All patients (n = 1044)	671/1044 (64.2)	329/623 (52.8)	342/421 (81.2)	0.0001	395/104 (37.83)	179/623 (28.73)	216/421 (51.30)	0.0001

DGBI: Disorder of gut-brain interaction.

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Table 5 Prevalence of psychological comorbidities in functional dyspepsia, irritable bowel syndrome and functional constipation patients with stratification according to overlap status¹

	Age	Male gender	Anxiety	Depression
Functional dyspepsia
Total (n = 463)	41.8 ± 12.0	208 (44.9%)	316 (68.3%)	195 (42.2%)
Overlapping (n = 300)	42.8 ± 11.9	129 (43%)	239 (79.6%)	149 (49.6%)
Non-overlapping (n = 163)	39.8 ± 11.9	79 (48.5%)	77 (47.3%)	46 (28.3%)
P value (a vs b)	0.0099	0.2824	0.0001	0.0001
Irritable bowel syndrome
Total (n = 168)	41.3 ± 12.9	97 (57.7%)	104 (61.9%)	65 (38.6%)
Overlapping (n = 69)	42.6 ± 11.3	36 (53.4%)	50 (72.5%)	33 (47.8%)
Non-overlapping (n = 99)	40.2 ± 13.9	61 (61.1%)	54 (54.5%)	32 (32.4%)
P value (m vs n)	0.2371	0.267	0.0237	0.0534
Functional constipation
Total (n = 188)	42.6 ± 12.7	92/188 (48.93%)	140/188 (74.5%)	93/188 (49.4%)
Overlapping (n = 124)	42.84 ± 12.7	49/124 (39.5%)	100/124 (80.6%)	67/124 (54.1%)
Non-overlapping (n = 64)	42.3 ± 12.7	43/64 (67.2%)	41/64 (64.1%)	25/64 (39.1%)
P value (x vs y)	0.7984	0.0004	0.0201	0.0647

¹a and b define the group overlapping vs non-overalpping, respectively for functional dyspepsia to help illustrate P-value computation. Similarly, m and n for Irritable bowel syndrome and lastly, x and y for functional constipation.

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Table 6 Distribution of anxiety and depression severity among patients with single vs overlapping disorders of gut-brain interaction

Severity	Single DGBI (n = 623)	Overlapping DGBIs (n = 421)	P value
Severity of anxiety
Mild anxiety (GAD-7 = 5 to 9)	281 (45.1%)	265 (62.9%)	0.0009
Moderate anxiety (GAD-7 = 10 to 14)	30 (4.8%)	53 (12.6%)
Severe anxiety (GAD-7 = 15 to 21)	8 (1.3%)	24 (5.7%)
Severity of depression
Mild depression (PHQ-9 = 5 to 9)	160 (25.7%)	194 (46.1%)	0.0254
Moderate depression (PHQ-9 = 10 to 14)	13 (2.1%)	19 (4.5%)
Moderately severe depression (PHQ-9 = 15 to 19)	7 (1.1%)	3 (0.7%)

GAD-7: Generalized Anxiety Disorder 7-item; PHQ-9: Patient Health Questionnaire 9-item.

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Table 7 Univariate and multivariate logistic regression analysis of factors associated with depression and anxiety in patients with disorders of gut-brain interactions

Predictor	Depression				Anxiety
	Univariate		Multivariate		Univariate		Multivariate
	OR (95%CI)	P value	Adjusted OR (95%CI)	P value	OR (95%CI)	P value	Adjusted OR (95%CI)	P value
Age (years)	1.01 (0.997-1.02)	0.181			1.01 (0.997-1.02)	0.147
Male sex	0.43 (0.33-0.56)	< 0.001	0.43 (0.32-0.58)	< 0.001	0.40 (0.31-0.52)	< 0.001	0.41 (0.30-0.56)	< 0.001
Disease duration	1.09 (1.05-1.13)	< 0.001	1.09 (1.04-1.14)	0.0002	1.07 (1.02-1.11)	0.002	1.06 (1.01-1.11)	0.016
Overlap DGBI	2.91 (1.55-5.46)	0.001	2.37 (1.20-4.68)	0.013	3.87 (2.89-5.17)	< 0.001	3.21 (1.59-6.49)	0.001
Esophageal disorder	1.12 (0.86-1.46)	0.391			1.60 (1.21-2.11)	0.001	1.53 (0.74-3.17)	0.251
Gastroduodenal disorder	1.93 (1.44-2.59)	< 0.001	1.35 (0.64-2.84)	0.436	1.42 (1.07-1.88)	0.015	1.41 (0.62-3.22)	0.408
Bowel disorder	1.31 (1.02-1.69)	0.037	1.31 (0.66-2.59)	0.435	1.12 (0.86-1.45)	0.408
Centrally mediated pain disorder	1.08 (0.60-1.95)	0.798			1.71 (0.88-3.32)	0.116
Gallbladder/SOD disorder	0.91 (0.30-2.74)	0.869			1.40 (0.43-4.48)	0.575
Anorectal disorder	0.83 (0.49-1.41)	0.494			0.82 (0.49-1.38)	0.459

DGBI: Disorders of gut-brain interaction; OR: Odds ratio; CI: Confidence interval; SOD: Sphincter of oddi dysfunction.

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Citation: Goyal MK, Goyal O, Wander P, Kaur J, Prashar G, Goyal P, Sood A. Anxiety and depression in Rome IV disorders of gut–brain interaction: Prevalence, clinical impact, and temporal association. World J Psychiatry 2026; 16(8): 119686
URL: https://www.wjgnet.com/2220-3206/full/v16/i8/119686.htm
DOI: https://dx.doi.org/10.5498/wjp.119686

Goyal MK, Goyal O, Wander P, Kaur J, Prashar G, Goyal P, Sood A. Anxiety and depression in Rome IV disorders of gut–brain interaction: Prevalence, clinical impact, and temporal association. World J Psychiatry 2026; 16(8): 119686 [DOI: 10.5498/wjp.119686]

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