Mental health risks in children with food allergies: a population-based comparison of food allergies with other chronic conditions.

Children with chronic diseases face a higher risk of mental health disorders. However, the cognitive consequences of food allergies (FA), which are not classified as a chronic disease, remain insufficiently researched. The objective of this study is to examine the association between FA and mental health in children and adolescents, compared to children and adolescents without FA (controls) and those with other chronic conditions but no history of FA. This is a retrospective cohort study using IQVIA Medical Research Data from UK primary care practices. Five cohorts of children aged 0-18 between 2000 and 2021 were defined: FA, control, asthma, atopic dermatitis (AD), and type 1 diabetes (T1D). The study included 1,130,721 children without FA (control), 23,263 with FA, 136,453 with asthma, 207,575 with AD, and 4835 with T1D. Compared to control, FA patients had higher risks of eating disorders (hazard ratio (HR) 1.85, 95% CI 1.42-2.41), anxiety (HR 1.35, 95% CI 1.25-1.45), and depression (HR 1.24, 95% CI 1.11-1.39). FA patients had lower depression risk than asthma and T1D patients (HR 0.77, 95% CI 0.68-0.87, 0.64, 95% CI 0.54-0.76, respectively) and lower anxiety risk than asthma patients (HR 0.86, 95% CI 0.79-0.91). FA patients' risk of eating disorders was not significantly different from asthma and T1D patients (HR 1.17, 95% CI 0.88-1.55, 1.58, 95% CI 0.81-3.10, respectively) but was significantly higher than in the AD group (HR 1.43, 95% CI 1.07-1.90).

Conclusion: This study indicates that children with FA face elevated risks of anxiety, depression, and eating disorders compared to children without FA, and that these risks vary when compared to children with other chronic conditions. These findings highlight the need for integrated mental health support in FA management and greater awareness of FA's psychological impact among healthcare providers.

What is known: • Children with chronic illnesses such as asthma and diabetes are known to have an elevated risk of mental health disorders. However, research on the mental health impact of food allergies remains limited.

What is new: • This study reveals that children with FA have significantly increased risks of anxiety, depression, and eating disorders compared to children without FA and provides comparative insights into the mental health risks of FA relative to other chronic conditions like asthma, atopic dermatitis, type 1 diabetes, and healthy controls.