Celiac disease is associated with a higher rate of mental disorders in adults, but the risk in children with celiac disease had yet to be established. This study aimed to review existing research on mental health concerns in pediatric celiac disease and propose a research and clinical agenda for the treatment of these conditions. The researchers found that children with celiac disease have a 1.2-1.8 higher risk of psychological conditions such as depression, mood disorders, behavioral problems, ADHD, eating disorders, autism, and other intellectual disabilities.
Mental health disorders associated with chronic illness present an increased burden for patients and caretakers by causing higher medical care costs, poorer diet adherence and long-term complications. Among the 26 publications reviewed, several studies found elevated risk for psychological conditions or symptoms in children with celiac disease. However, many studies were limited by small sample sizes and inconsistent approaches to measuring psychological symptoms.
One of the authors of the systematic review, Shayna Coburn, PhD, states “We found that children with celiac disease have a higher risk of symptoms like anxiety, depression, and behavior problems, and discussed some weak evidence that eating disorders and developmental delays may also be connected to CD. However, there is a major need to study these questions further in larger samples of children. In our paper, we proposed a clinical and research agenda based on our findings, which raises the importance of psychological screening and care as a routine part of celiac disease treatment and research.”
These findings highlight the need to perform mental health screening in patients with celiac disease and to develop psychological guidelines for celiac disease care. Children with psychological disorders and celiac disease may have more difficulty adhering to a gluten-free diet and coping with the emotional burden associated with its management. Children whose psychological symptoms are not well controlled may also benefit from celiac disease screening, as their psychological symptoms may be a sign of undiagnosed celiac disease. It should be a priority to assess for a broad range of psychological conditions among children with celiac disease.
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