Psychotropic medication use among patients with celiac disease

Psychological, Psychiatric, and Organic Brain Manifestations of Celiac Disease

INTRODUCTION

Celiac disease is an autoimmune condition that affects approximately 1% of the population worldwide. Although its main impact often concerns the small intestine, resulting in villous atrophy and nutrient malabsorption, it can also cause systemic manifestations, particularly when undiagnosed or left untreated.

METHOD

Attention is directed to the possible psychological, psychiatric, and organic brain manifestations of celiac disease. Specific topics related to the influence and risk of such manifestations with respect to celiac disease are defined and discussed. Overall, eighteen main topics are considered, sifted from over 500 references.

RESULTS

The most often studied topics were found to be the effect on quality of life, organic brain dysfunction and ataxia, epilepsy, Down syndrome, generalized psychological disorders, eating dysfunction, depression, and schizophrenia. For most every topic, although many studies report a connection to celiac disease, there are often one or more contrary studies and opinions. A bibliographic analysis of the cited articles was also done. There has been a sharp increase in interest in this research since 1990. Recently published articles tend to receive more referencing, up to as many as 15 citations per year, suggesting an increasing impact of the topics. The number of manuscript pages per article has also tended to increase, up to as many as 12 pages. The impact factor of the publishing journal has remained level over the years.

CONCLUSION

This compendium may be useful in developing a consensus regarding psychological, psychiatric, and organic brain manifestations that can occur in celiac disease and for determining the best direction for ongoing research focus.

The Relationship between FFMQ Mindfulness and Harmony in Life among Patients with Celiac Disease

Background

Patients with Celiac Disease (CD) experience psychological disorders and emotion-regulation disruptions. Although following a gluten-free diet alleviates their symptoms, these patients report social relationship problems.

Objective

The first aim of this study was to analyze the level of FFMQ mindfulness (describing emotions, acting with awareness, observing, non-judging of inner experience, and non-reactivity to inner experience) and harmony in life (HiL) in patients with CD. The second goal was to examine the relationship between the FFMQ and HiL scales in patients with CD. The third was to detect the effects of the duration of the illness, education level, and employment status on FFMQ-measured mindfulness and HiL.

Design

The study involved 111 Turkish patients with CD (N Females = 75, 67.6%) living in Turkey. The patients filled out the FFMQ and HiL questionnaires via a google form survey. The duration of their diagnosis, age, employment status, and education level were nominal variables. A Pearsons' correlation test, independent t-test, multiple linear regression, and one-way ANO VA were implemented.

Results

The results showed that patients with CD had a low level of HiL. The total FFMQ score was positively related to the HiL scale. Education and duration of diagnosis had a significant impact on the FFMQ and HiL scores. Age affected the level of describing emotions, and employment status had a strong effect on acting with awareness. However, gender affected neither the FFMQ nor HiL levels.

Conclusion

The results showed that patients with CD expressed a low level of HiL. Non-reactivity to inner experience, observing, and acting with awareness were positive predictors of the HiL scores. Moreover, since the HiL and FFMQ scales showed high internal consistency, the FFMQ and HiL questionnaires can be used in further studies of patients with CD.

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

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.