Celiac Disease Autoimmunity Has Real Impacts on Kids' Psychology

Celiac.com 02/28/2017 - It's no secret that psychological symptoms can be associated with celiac disease, but until recently, no one had really done a solid prospective study on children.

A research team has now done just that. In this case, they looked at a group of children with celiac disease autoimmunity (CDA), which is defined as persistently positive celiac disease–associated tissue transglutaminase autoantibodies (tTGA). As part of their study, the researchers looked at a screening population of genetically at-risk children. They assessed psychological functioning in children as reported by mothers, and then compared the results with a comparable group of children without celiac disease autoimmunity.

Celiac.com Sponsor (A12):
They also investigated differences in psychological symptoms based on mothers' awareness of their child's celiac disease autoimmunity status.

The research team included Laura B. Smith, Kristian F. Lynch, Kalle Kurppa, Sibylle Koletzko, Jeffrey Krischer, Edwin Liu, Suzanne Bennett Johnson, Daniel Agardh, and The TEDDY study group. The study, titled Environmental Determinants of Diabetes in the Young, followed 8,676 children to identify triggers of type 1 diabetes and celiac disease. Children were tested for tTGA beginning at 2 years of age. The researchers used the Achenbach Child Behavior Checklist to assess child psychological functioning at 3.5 and 4.5 years of age.

At 3.5 years, 66 mothers who were not aware that their child had celiac disease autoimmunity reported more child anxiety and depression, aggressive behavior, and sleep problems than 3,651 mothers of children without celiac disease autoimmunity. Unaware-celiac disease autoimmunity mothers also reported more child anxiety and depression, withdrawn behavior, aggressive behavior, and sleep problems than 440 mothers aware of their child's celiac disease autoimmunity status. At 4.5 years, there were no differences.

At 3½ years-old, children with persistently positive celiac disease–associated tTGA had substantially more reports of child depression and anxiety, aggressive behavior, and sleep problems by mothers who were not aware of their child's celiac disease autoimmunity status.

Mothers with knowledge of their child's celiac disease autoimmunity status made fewer reports of psychological symptoms, which indicates that awareness of the child's tTGA test status makes mother's less likely to report symptoms.

That the differences seem to disappear by age 4.5 is encouraging, but also puzzling. Why do they seem to disappear? What specifically causes them in the first place? This is the first study to date on this particular aspect of celiac disease and related conditions in children. It will likely not be the last. As we learn more from studies like this one, the ways we test for, monitor, and even treat celiac disease will likely improve.

Source:

•  Pediatrics, February 2017