{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:04:26Z","timestamp":1777723466480,"version":"3.51.4"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Fatigue is highly prevalent in children with inflammatory bowel disease (IBD), even during clinical remission. This suggests a role for transdiagnostic factors\u2014lifestyle, psychological, and social influences not specific to the disease. This study aimed to assess the prevalence of severe fatigue in pediatric IBD and evaluate its associations with both IBD\u2010focused and transdiagnostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children with IBD ages 8\u201318 from the PROactive cohort completed the Pediatric Quality of Life Inventory\u2014Multidimensional Fatigue Scale. IBD\u2010focused clinical data were extracted from electronic health records. Transdiagnostic factors were assessed using validated patient\u2010reported outcome measures. Associations with fatigue were examined using linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 127 patients (mean age 14.9\u2009\u00b1\u20092.7 years; 43% male), most were in clinical remission. One hundred six patients self\u2010reported fatigue, and 99 parents reported their child\u2032s fatigue. Severe fatigue was self\u2010reported by 29%. Of IBD\u2010focused factors, only disease activity (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.40) and comorbidity (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.18) showed significant associations with fatigue. Of transdiagnostic factors, lower physical, emotional, and social functioning; poorer sleep quality; less physical activity; more pain, anxiety, and depressive symptoms; lower life satisfaction and self\u2010rated health; and increased school absence and pressure were significantly associated with more fatigue. Backward selection retained only transdiagnostic factors in the multivariate model, which explained 78% of fatigue variance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Fatigue is common in children with IBD and is more strongly associated with transdiagnostic than disease\u2010focused factors. These findings highlight the importance of integrative care strategies that address modifiable psychosocial and lifestyle domains to reduce fatigue and improve functioning in children with IBD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70317","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T11:06:02Z","timestamp":1766487962000},"page":"699-707","source":"Crossref","is-referenced-by-count":1,"title":["Fatigue in pediatric inflammatory bowel disease: Explained by transdiagnostic and disease\u2010focused factors"],"prefix":"10.1002","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8857-7749","authenticated-orcid":false,"given":"Maartje D.","family":"Stutvoet","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht University Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouk","family":"Vroegindeweij","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht University Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa Z.","family":"Toonen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merel M.","family":"Nap\u2010Van der Vlist","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht University Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna W.","family":"Hoefnagels","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht University Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anemone","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Wilhelmina Children's Hospital University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanne L.","family":"Nijhof","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht University Utrecht the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i5.632"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpn3.12039"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.01.022"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000003905"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-018-0091-9"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.11.1487"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/22.5.723"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(01)00291-4"},{"key":"e_1_2_8_10_1","unstructured":"Crohn & Colitis NL. 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