Associations between psychological factors and functional dyspepsia symptoms with consideration of gender differences

Functional dyspepsia (FD) is a common disorder of gut–brain interaction in which psychological factors may influence symptom presentation. This cross-sectional study examined the associations between stress resilience, somatization, subjective well-being (SWB), and FD symptoms, with a particular focus on gender differences. Adult patients (≥ 18 years) presenting with dyspeptic symptoms and referred for their first upper gastrointestinal endoscopy were recruited at the University Clinical Hospital of Mostar, Bosnia and Herzegovina. Psychological factors were assessed using validated questionnaires, and FD symptom characteristics included FD subtypes, intensity, frequency, and duration. Group differences were analysed using appropriate parametric or non-parametric tests, whereas multinomial logistic regression and multivariate multiple regression were used to evaluate associations between psychological variables and FD outcomes. Lower resilience and SWB, along with a higher somatization, were significantly associated with membership to the mixed FD type. Higher somatization was associated with more severe symptoms, and higher age was associated with longer symptom duration. Higher SWB scores corresponded, although marginally, to less frequent symptom reporting. Several variables differed by sex/gender. These findings support the role of gut–brain interactions in FD and may inform the development of targeted psychological interventions. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-026-46838-7.