Frequency of Celiac Disease in Attention‐deficit/Hyperactivity Disorder

Güngör, Serdal; Celıloğlu, Özgü Suna; Özcan, Özlem; Raif, Sabiha Güngör; Selimoğlu, Mukadder Ayşe

doi:10.1097/mpg.0b013e318272b7bc

Cited by 34 publications

(35 citation statements)

References 43 publications

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“…Clearly such findings are relevant to clinical practice, as both ASD and ADHD patients are often advised to adopt a GFD to reduce behavioural problems [38,[40][41][42][43][44][45][46]. There is no rational for doing so unless the patient has been tested for CD prior to adopting a GFD.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of CD in ADHD was investigated by two cross sectional studies [45,46]. One out of 401 ADHD participants was diagnosed with CD, making the pooled prevalence of CD in ADHD 0.3% [45]. were found to have ADHD resulting in a pooled prevalence of ADHD in CD of 1.4%.…”

Section: Asd and Adhdmentioning

confidence: 99%

“…Thirdly, despite much deliberation surrounding increases in GI symptoms and intestinal permeability in ASD mentioned in these articles, only two tested these theories [38,39]. Lastly, it is also worth considering that the majority of these studies for both ASD and ADHD concern pediatric populations, which is understandable as ASD and ADHD are both prevalent in childhood [31,34,35,[37][38][39][40][41][42]45,46]. However, unlike ASD and ADHD, CD is not confined to childhood and is very prevalent later on in life [45].…”

Section: Limitations Of Studies In Adhd and Asdmentioning

confidence: 99%

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Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis

2020

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Background: Coeliac disease (CD) is increasingly prevalent and is associated with both gastrointestinal (GI) and extra-intestinal manifestations. Psychiatric disorders are amongst extra-intestinal manifestations proposed. The relationship between CD and such psychiatric disorders is not well recognised or understood. Aim: The aim of this systematic review and meta-analysis was to provide a greater understanding of the existing evidence and theories surrounding psychiatric manifestations of CD. Methodology: An online literature search using PubMed was conducted, the prevalence data for both CD and psychiatric disorders was extracted from eligible articles. Meta analyses on odds ratios were also performed. Results: A total of 37 articles were included in this review. A significant increase in risk was detected for autistic spectrum disorder (OR 1.53, 95% CI 1.24–1.88, p < 0.0001), attention deficit hyperactivity disorder (OR 1.39, 95% CI 1.18–1.63, p < 0.0001), depression (OR 2.17, 95% CI 2.17–11.15, p < 0.0001), anxiety (OR 6.03, 95% CI 2.22–16.35, p < 0.0001), and eating disorders (OR 1.62, 95% CI 1.37–1.91, p < 0.00001) amongst the CD population compared to healthy controls. No significant differences were found for bipolar disorder (OR 2.35, 95% CI 2.29–19.21, p = 0.43) or schizophrenia (OR 0.46, 95% CI 0.02–10.18, p = 0.62). Conclusion: CD is associated with an increased risk of depression, anxiety, eating disorders as well as ASD and ADHD. More research is required to investigate specific biological explanations as well as any effect of gluten free diet.

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Section: Discussionmentioning

confidence: 99%

Section: Asd and Adhdmentioning

confidence: 99%

Section: Limitations Of Studies In Adhd and Asdmentioning

confidence: 99%

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Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis

2020

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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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“…ADHD has also been hypothesised to be a hypersensitivity disorder, with a disrupted immune regulation contributing to its aetiology [10]; i.e. ADHD has comorbidity with both Th1- and Th2-mediated disorders and several related genes have immune functions [9, 10, 15–18]. Ceylan et al observed increased levels of adenosine deaminase, a marker of cellular immunity, and of the oxidative enzymes xanthine oxidase (XO) and nitric oxide synthase, and decreased levels of the antioxidant enzymes glutathione- S -transferase and paraoxonase-1.…”

Section: Introductionmentioning

confidence: 99%

Effect of Pycnogenol® on attention-deficit hyperactivity disorder (ADHD): study protocol for a randomised controlled trial

Verlaet

Ceulemans

Verhelst

et al. 2017

Trials

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BackgroundMethylphenidate (MPH), the first choice medication for attention-deficit hyperactivity disorder (ADHD), is associated with serious adverse effects like arrhythmia. Evidence on the association of ADHD with immune and oxidant-antioxidant imbalances offers potential for antioxidant and/or immunomodulatory nutritional supplements as ADHD therapy. One small randomised trial in ADHD suggests, despite various limitations, therapeutic benefit from Pycnogenol®, a herbal, polyphenol-rich extract.MethodsThis phase III trial is a 10-week, randomised, double-blind, placebo and active treatment controlled multicentre trial with three parallel treatment arms to compare the effect of Pycnogenol® to MPH and placebo on the behaviour of 144 paediatric ADHD and attention-deficit disorder (ADD) patients. Evaluations of behaviour (measured by the ADHD-Rating Scale (primary endpoint) and the Social-emotional Questionnaire (SEQ)), immunity (plasma cytokine and antibody levels, white blood cell counts and faecal microbial composition), oxidative stress (erythrocyte glutathione, plasma lipid-soluble vitamins and malondialdehyde and urinary 8-OHdG levels, as well as antioxidant enzyme activity and gene expression), serum zinc and neuropeptide Y level, urinary catecholamines and physical complaints (Physical Complaints Questionnaire) will be performed in week 10 and compared to baseline. Acceptability evaluations will be based on adherence, dropouts and reports of adverse events. Dietary habits will be taken into account.DiscussionThis trial takes into account comorbid behavioural and physical symptoms, as well as a broad range of innovative immune and oxidative biomarkers, expected to provide fundamental knowledge on ADHD aetiology and therapy. Research on microbiota in ADHD is novel. Moreover, the active control arm is rather unseen in research on nutritional supplements, but of great importance, as patients and parents are often concerned with the side effects of MPH.Trial registrationClinicaltrials.gov number: NCT02700685. Registered on 18 January 2016. EudraCT 2016-000215-32. Registered on 4 October 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1879-6) contains supplementary material, which is available to authorized users.

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Frequency of Celiac Disease in Attention‐deficit/Hyperactivity Disorder

Abstract: The seropositivity rates for CD were found similar in ADHD and control groups. Thus, neither routine screening for CD nor empirical recommendation of gluten-free diet seems necessary in children with ADHD.

Cited by 34 publications

References 43 publications

Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis

Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis

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

Effect of Pycnogenol® on attention-deficit hyperactivity disorder (ADHD): study protocol for a randomised controlled trial

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