Assessment of anxiety in children with functional gastrointestinal disorders accompanied by abdominal pain during martial law

Background. Contemporary pediatric practice witnesses an increasing prevalence of comorbid functional gastrointestinal disorders and anxiety disorders in children, particularly in the context of prolonged stress during martial law. The lack of standardized Ukrainian-language tools for pediatric anxiety screening significantly complicates timely diagnosis and comprehensive care provision. This study represents the first step toward addressing this challenge in Ukraine through cross-cultural adaptation and comprehensive psychometric validation of the SCARED-C (Screen for Child Anxiety Related Emotional Disorders — Child Version). The implementation of this validated instrument will enable effective screening for anxiety disorders in children with functional gastrointestinal disorders. The purpose was to investigate anxiety disorders in children with functional gastrointestinal disorders accompanied by abdominal pain under martial law conditions through the development, cross-cultural adaptation, assessment of psychometric properties (reliability and validity) of the Ukrainian-language version of the SCARED-C screening tool, followed by its clinical implementation. Materials and methods. The study included 176 patients aged 6 to 17 years with functional gastrointestinal disorders. All of them underwent clinical evaluation comprising comprehensive health assessment with detailed history taking, physical examination, and anxiety disorder screening using the validated Ukrainian version of the SCARED-C. Results. The Ukrainian adaptation of the SCARED-C exhibited robust psychometric cha­racteristics (Cronbach’s α = 0.7; intraclass correlation coefficient = 0.973, p < 0.01), supporting its validity for anxiety screening. Children with functional gastrointestinal disorders and abdominal pain scored significantly higher on total anxiety measures, particularly on the panic disorder (p < 0.01) and somatic symptoms (p < 0.01) subscales, compared to controls. Notably, symptoms with visceral correlates (abdominal pain, nausea, and palpitations) were prominently elevated. Of clinical relevance, patients with irritable bowel syndrome scored higher on generalized anxiety disorder metrics (p < 0.01), highlighting the importance of tailored diagnostic evaluation in this subgroup. The obtained data substantiate the feasibility of using the adapted SCARED-C in clinical practice for the early detection of anxiety disorders in children with the specified pathology. Conclusions. The study results confirm the efficacy of the adapted Ukrainian version of the SCARED-C scale as a standardized screening tool for anxiety disorders in children with functional gastrointestinal disorders. This instrument enables optimization of diagnostic algorithms and a differentiated approach to managing patients with comorbid conditions.