A Preliminary Investigation of ADHD Symptoms in Persons With Celiac Disease

Niederhofer, Helmut; Pittschieler, K

doi:10.1177/1087054706292109

Cited by 50 publications

(52 citation statements)

References 29 publications

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“…These results support previous studies documenting depression, anxiety, and sleep problems as possible manifestations of celiac disease. 1,3, 5 The current study provides even greater support for this association because mothers were unaware of their child’s CDA status at the time of symptom reporting. Interestingly, when mothers are aware of their child’s CDA, they report levels of psychological symptoms that are similar to, or lower than, mothers of children with no CDA.…”

Section: Discussionmentioning

confidence: 65%

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Psychological Manifestations of Celiac Disease Autoimmunity in Young Children

Smith¹,

Lynch

Kurppa

et al. 2017

Pediatrics

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BACKGROUND AND OBJECTIVES Psychological symptoms can be associated with celiac disease; however, this association has not been studied prospectively in a pediatric cohort. We examined mother report of psychological functioning in children persistently positive for tissue transglutaminase autoantibodies (tTGA), defined as celiac disease autoimmunity (CDA), compared with children without CDA in a screening population of genetically at-risk children. We also investigated differences in psychological symptoms based on mothers’ awareness of their child’s CDA status. METHODS The Environmental Determinants of Diabetes in the Young study followed 8676 children to identify triggers of type 1 diabetes and celiac disease. Children were tested for tTGA beginning at 2 years of age. The Achenbach Child Behavior Checklist assessed child psychological functioning at 3.5 and 4.5 years of age. RESULTS At 3.5 years, 66 mothers unaware their child had CDA reported more child anxiety and depression, aggressive behavior, and sleep problems than 3651 mothers of children without CDA (all Ps ≤ .03). Unaware-CDA mothers also reported more child anxiety and depression, withdrawn behavior, aggressive behavior, and sleep problems than 440 mothers aware of their child’s CDA status (all Ps ≤.04). At 4.5 years, there were no differences. CONCLUSIONS In 3.5-year-old children, CDA is associated with increased reports of child depression and anxiety, aggressive behavior, and sleep problems when mothers are unaware of their child’s CDA status. Mothers’ knowledge of their child’s CDA status is associated with fewer reports of psychological symptoms, suggesting that awareness of the child’s tTGA test results affects reporting of symptoms.

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Section: Discussionmentioning

confidence: 65%

“…1,2 The condition may also cause psychological manifestations such as depression, cognitive impairment, sleep problems, and attention deficits. 3–5 Although the etiology remains to be confirmed, psychological symptoms may be the result of nutrient malabsorption or increased levels of proinflammatory cytokines affecting mental and emotional functioning. 6 …”

mentioning

confidence: 99%

Psychological Manifestations of Celiac Disease Autoimmunity in Young Children

Smith¹,

Lynch

Kurppa

et al. 2017

Pediatrics

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“…For instance, in one study, the beginning of a standard gluten-free diet, or a vitamin B-6-supplemented gluten-free diet was shown to improve internalizing symptoms in adults [25]. In line with this, another study reported that ADHD-like symptoms were markedly overrepresented among untreated CD patients (age range: 3 to 57) and that a gluten-free diet improved symptoms within a short period of time [26]. Finally, the institution of a gluten-free diet in a group of children with CD was also shown to improve neurological symptoms such as headaches in 77% of the cases [12].…”

Section: Introductionmentioning

confidence: 93%

Compliant gluten-free children with celiac disease: an evaluation of psychological distress

et al. 2011

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BackgroundChildren with chronic illnesses are known to have increased risks for emotional and behavioral problems. In the present study, children and adolescent suffering from celiac disease (CD) were compared with healthy controls to assess differences in the psychological profile.MethodsA total of 100 well-treated and compliant CD patients (65 females/35 males; age mean ± SD: 10.38 ± 2.71) were compared to 100 normal controls (58 females/42 males; age mean ± SD: 11.47 ± 2.61). Emotional and behavioral problems were assessed by the Child Behavior Checklist (CBCL), the Children's Depression Inventory (CDI) and the Multidimensional Anxiety Scale for Children (MASC).ResultsSubjects with CD self-reported an increased rate of anxiety and depression symptoms and showed higher scores in "harm avoidance" and "somatic complaints", in the CBCL parent-report questionnaire, as compared to healthy control subjects. Furthermore, gender differences could be observed in the group of CD patients, with males displaying significantly higher CBCL externalizing scores, in social, thought and attention problems, as compared to female, who in turns showed more prominent internalizing symptoms such as depression.ConclusionsThe increased rate of emotional and behavioral problems in children and adolescent with CD emphasizes the importance of an early detection of mental health problems in these children.

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“…There is also preliminary research to suggest that coeliac disease is over-represented in people with ADHD (Niederhofer 2011;Niederhofer and Pittschieler 2006), although negative findings have also been reported (Gungor et al 2013). However, these medical and psychiatric disease cannot solely account for the increased O&NS in ADHD as in several studies these comorbidities were adequately controlled for in analyses.…”

Section: Potential Causes Of Oandns In Adhdmentioning

confidence: 99%

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

Lopresti

2015

ADHD Atten Def Hyp Disord

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Attention deficit hyperactivity disorder (ADHD) has a complex etiology although theories associated with disturbances in dopaminergic and noradrenergic activity are most commonly cited.The importance of these catecholamines in ADHD is supported by its effective treatment utilising stimulant and non-stimulant medications that modify their activity. Recently there has been interest in oxidative and nitrosative stress (O&NS) in ADHD and its potential to contribute to this condition. In this article, research investigating O&NS in ADHD is reviewed and its impact on catecholaminergic activity and neurological structure is discussed. Lifestyle, environmental, ADHD is most commonly treated with stimulant medications such as methylphenidate and amphetamines, non-stimulants such as atomoxetine, and alpha2-adrenergic agonists such as clonidine and guanfacine. Through their effects on dopamine and noradrenaline transporters, stimulants inhibit the reuptake of dopamine and noradrenaline, thereby increasing the extracellular levels of these neurotransmitters. These stimulants also inhibit monoamine oxidase, the enzyme that metabolises these catecholamines (Wilens et al. 2011). Atomoxetine works as a selective reuptake inhibitor of noradrenaline leading to its increased extracellular concentration (Garnock- Jones and Keating 2009).While effective, these medications are associated with several adverse effects. These include loss of appetite, growth delay and sleep disturbances (Cortese et al. 2013). It is important to note that despite their widely accepted short-term efficacy, the long-term effectiveness of pharmacological treatments on social, educational and occupational functioning in people with ADHD continues to be debated (Huang and Tsai 2011;Langberg and Becker 2012;Nijmeijer et al. 2008). On a positive note, recent analyses using the Swedish national registrar suggests that long-term stimulant use in people with ADHD is associated with reduced rates of substance use, criminality, and serious traffic accidents (Chang et al. 2014a;Chang et al. 2014b;Lichtenstein et al. 2012).Despite wide appreciation of catecholaminergic theories associated with ADHD, there has been increased research into other biological mechanisms associated with ADHD. For example, in psychiatry there has been interest in immune-inflammatory pathways and oxidative and nitrosative stress (O&NS). In particular, it has been confirmed through recent meta-analyses that depression is Increased O&NS has also been found in bipolar disorder (Andreazza et al. 2008;Brown et al. 2014),

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A Preliminary Investigation of ADHD Symptoms in Persons With Celiac Disease

Cited by 50 publications

References 29 publications

Psychological Manifestations of Celiac Disease Autoimmunity in Young Children

Psychological Manifestations of Celiac Disease Autoimmunity in Young Children

Compliant gluten-free children with celiac disease: an evaluation of psychological distress

Oxidative and nitrosative stress in ADHD: possible causes and the potential of antioxidant-targeted therapies

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