Psychosomatic correlates of war distress in children and adolescents

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Background. In the conditions of a full-scale war, the risk of developing psychosomatic, primarily functional disorders of the gastrointestinal tract in children caused by psychosocial distress, changes in family structure and living conditions increases significantly. The study of the pathogenesis of stress-induced gastrointestinal disorders in children and adolescents under conditions of military distress is of key importance for modern medicine, since chronic psychoemotional stress is one of the leading factors of gastrointestinal dysfunction, which is realized through neuroendocrine and immunoinflammatory mechanisms. An in-depth understanding of these processes allows not only to identify high-risk groups, but also to develop targeted, evidence-based strategies for the prevention and support of children’s somatic and mental health in crisis conditions. In the context of war, when environmental factors, social instability, and traumatic experiences interact in a synergistic negative impact on children’s health, the timely development and implementation of such strategies becomes a prerequisite for reducing the burden of disease and ensuring long-term resilience of the population. Purpose – is to identify the relationship between stress factors and symptoms associated with functional gastrointestinal disorders to create differentiated approaches to the management of these disease states in an interdisciplinary approach. Materials and methods. In 2023–2025, a study was conducted of 205 Ukrainian families whose children had gastrointestinal complaints due to military stress. The assessment was carried out using an adapted questionnaire based on the Rome IV criteria (2016), supplemented by the CATS-2 (2022) and CYRM-R (2018) scales to study traumatic experience and psychological resilience. Results. The specifics of the stress response in children affected by war and forced to adapt to new living conditions were determined. It was found that children who had moved to EU countries since the beginning of the full-scale war had a more pronounced and wider range of gastrointestinal complaints compared to the group of children who did not change their location, despite the war in Ukraine and the proximity of the war zone. The findings emphasize the need to develop specific measures to support the mental and physical health of children affected by war, with a particular focus on the prevention and treatment of stress-induced gastrointestinal disorders. Conclusions. The study has several innovative aspects that expand the understanding of the impact of war stressors on children’s gastrointestinal health. The comparative design with four groups (child «refugees» in the EU; child «refugees» who returned from the EU to Ukraine; internally displaced persons; those who did not change their location due to the proximity of hostilities) allowed to quantify the «dose» of stress at each stage of adaptation and to identify specific patterns of functional gastrointestinal disorders.

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