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