Assessing the psychological effects of eosinophilic esophagitis: a study on anxiety, self-concept, and depression in pediatric patients.

UNLABELLED: Eosinophilic esophagitis (EoE) is a chronic inflammatory condition of the esophagus that may impose a substantial psychological burden on affected children. Its impact on self-concept, anxiety, and depression has not been well characterized. This study aimed to investigate levels of self-concept, anxiety, and depression in children with EoE and to evaluate the psychological burden associated with the disease. Sixty-two children aged 6-18 years, including 31 patients with EoE and 31 controls without EoE, participated in the study. In the EoE group, psychological assessment was performed after at least 1 year of clinical follow-up and treatment; none of the patients were evaluated at the time of initial diagnosis. Psychological functioning was assessed using the Piers-Harris Children's Self-Concept Scale, the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Children's Depression Inventory (CDI), all validated in Turkish. Clinical characteristics, including symptom profile, disease duration, and medication use, were also recorded. The Mann-Whitney U-test was used for between-group comparisons. Children with EoE had significantly lower self-concept (Piers-Harris) scores and higher anxiety (SCARED) and depression (CDI) scores than controls (p < 0.001, p = 0.004, and p = 0.003, respectively). No significant associations were observed between psychological scores and general disease characteristics, including disease duration, medication use, or the presence of atopic comorbidities. CONCLUSION: Children with EoE demonstrated higher anxiety and depression scores and lower self-concept scores than controls despite having been followed and treated for at least 1 year before psychological assessment. These findings suggest that children with EoE may experience an increased psychological burden and support consideration of psychological assessment as part of multidisciplinary care. WHAT IS KNOWN: • Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease that can negatively affect quality of life through persistent symptoms, dietary restrictions, and repeated medical procedures. • Previous studies suggest that children with EoE may be at increased risk for anxiety and depression, but data remain limited, particularly in non-Western populations. WHAT IS NEW: • Turkish children with EoE showed significantly higher anxiety and depression scores and lower self-concept scores than healthy controls. • Feeding-related symptoms, particularly dysphagia and food impaction sensations, were associated with greater psychological distress, highlighting the need for routine psychological assessment in pediatric EoE care.