Psychological Functioning and Parent–Child Mental Health Interrelations in Pediatric Gastrointestinal Autoimmune Disorders

Purpose To examine psychological functioning and parent–child mental health in pediatric gastrointestinal autoimmune disorders. Child anxiety, depression, alexithymia, negative automatic thoughts and health-related quality of life were compared across inflammatory bowel disease (IBD), celiac disease and hepatopathy. Parental psychological functioning and parent–child associations were also assessed. Methods This cross-sectional study included 59 children aged 8–17 years with confirmed IBD, celiac disease or hepatopathy and one parent per child, recruited from a university pediatric gastroenterology department in Greece during 2024. Participants completed validated psychological questionnaires. Associations, paired parent–child comparisons and diagnostic-group differences were examined. Results Greater child alexithymia and more frequent negative automatic thoughts were associated with higher symptoms across all RCADS outcomes, whereas health-related quality of life was inversely associated with all outcomes. Parental alexithymia was associated with child-reported obsessive-compulsive symptoms, while six associations of parental depression, anxiety and alexithymia with parent-rated child outcomes remained significant. Parents rated child symptoms higher than children in all paired RCADS comparisons. Diagnostic comparisons suggested the greatest psychological burden and lowest health-related quality of life among children with Crohn’s disease. Conclusions Alexithymia and parent–child mental health emerged as important dimensions of psychological functioning in pediatric gastrointestinal and hepatological autoimmune disorders. Findings support multi-informant, family-centered psychological assessment within pediatric gastroenterology, while acknowledging shared-informant variance and the cross-sectional design.