Cognitive behavioral therapy for comorbid pediatric functional gastrointestinal disorders and anxiety: Systematic review and clinical applications

Abstract

Pediatric Functional Gastrointestinal Disorders (p-FGID) comprise one of the most common chronic conditions impacting global health. Conceptualized as gut-brain communication disorders, p-FGID are often exacerbated by and contribute to significant anxiety as well as functional impairment. Cognitive behavioral therapy is the gold standard psychosocial treatment for anxiety spectrum disorders. Prior research demonstrates a bidirectional link between p-FGID and anxiety symptoms, recommending CBT as the first line of treatment for both. While exposure is the potent ingredient for anxiety treatment, exposure is under-investigated in the treatment of p-FGID. The present brief systematic review synthesizes existent literature to describe the impact of CBT on p-FGID and anxiety symptoms in youth. The researchers systematically screened articles (n=23) located via Embase, Medline, and PsychINFO search. Eight studies meeting inclusion criteria were included for the final review. Three themes characterized the selected articles: (1) the impact of CBT on p-FGID symptoms, (2) the impact of CBT on health-related disability in youth with p-FGID, and (3) the impact of CBT on concurrent anxiety symptoms in youth with p-FGID. Key findings are summarized and implications for treatment are identified.