Celiac Disease Mental Health

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Daniel is a 14-year-old boy who was diagnosed with celiac disease at age  8.  He had  previously been adherent to a gluten-free diet, however, since starting ninth grade this year, his parents noticed that  he had  developed more abdominal pain, bloating, and diarrhea. After continued presence of symptoms, his parents suggested that  Daniel see  his pediatrician for evaluation, and  he disclosed that  he had  been eating foods with gluten since beginning his new school. Daniel expressed feelings of anger and  frustration that he had  to follow a special diet and  that  he wanted to ‘be like everyone else.


Liz is a 12-year-old girl with  type  1 diabetes and  celiac disease (diagnosed at ages 10 and  11, respectively). Liz has  a history of Generalized Anxiety Disorder (GAD) and  Attention-Deficit/Hyperactivity Disorder (ADHD), which had  previously been well-managed on medication (escitalopram and  methylphenidate).

However, in the  last six weeks, her  father noticed that Liz had  been increasingly more anxious. Despite her health being stable, Liz complained of stomachaches and  had  difficulty going to school. Liz’s father noted that  Liz was  more hesitant to eat  outside of the  home and  no longer wanted to spend time  at friends’ homes due  to concern about gluten exposure. Liz also had difficulty sleeping at night,  was  clingier towards her parents, and  experienced academic decline due  to difficulties concentrating and  missed school.



Samuel is a 5-year-old boy who was recently diagnosed with celiac disease. Samuel’s  mother requested a meeting with a psychologist for guidance on how to explain  celiac disease and  a gluten-free diet to Samuel. In particular, she  was concerned that  Samuel would not understand or comply with a gluten-free diet because he had  never experienced overt symptoms related to celiac disease. Samuel’s  mother also wanted ideas  on working with the  school and  how to talk with extended family about celiac disease.



Martha is a 12-year-old girl who comes for mental health treatment with  a previous diagnosis
of Generalized Anxiety Disorder (GAD) and “Chronic Shyness Syndrome” (which is not  an official mental health disorder, per the  DSM) by her  primary care doctor.  Martha presents with social  shyness, chronic stomachaches, fear of vomiting and  anxiety about being sick in front of others.



Gabriella is a 16-year-old female referred for psychiatric evaluation by her pediatrician due to concerns about depression. Initial medical assessment had  not  found any organic etiology for Gabriella’s recent increased fatigue, decreased appetite, and  low mood. Parents are concerned that  Gabriella is growing increasingly more socially  isolated and  struggling to attend school consistently.


Jason is an 8-year-old boy who presents for a first psychiatric evaluation for concerns about inattention, academic decline, and  oppositional behavior. Parents report Jason’s grades have dropped during third  grade, and  he is experiencing more disciplinary problems at school (e.g., talking  out  of turn,  not  following directions, out  of his seat). Parents described Jason has  been eating less, partly  because he is active and can’t sit still, but  he also complains of stomachaches and  feeling  uncomfortably full after  eating very little. Jason has  never been a ‘great eater’ and  has  always been small for his age.

Celiac Disease Mental Health