Psychological Manifestations of Celiac Disease Autoimmunity in Young Children

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 cel...

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Veröffentlicht in:	Pediatrics (Evanston) Jg. 139; H. 3
Hauptverfasser:	Smith, Laura B, Lynch, Kristian F, Kurppa, Kalle, Koletzko, Sibylle, Krischer, Jeffrey, Liu, Edwin, Johnson, Suzanne Bennett, Agardh, Daniel
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States 01.03.2017
Schlagworte:	Aggression - psychology Anxiety - etiology Autoantibodies - blood Celiac Disease - immunology Celiac Disease - psychology Child, Preschool Depression - etiology Europe Female GTP-Binding Proteins - immunology Humans Longitudinal Studies Male Mothers Prospective Studies Protein Glutamine gamma Glutamyltransferase 2 Sleep Wake Disorders - etiology Transglutaminases - immunology United States United States Europe
ISSN:	1098-4275, 1098-4275
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Abstract	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. 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. 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 s ≤ .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 Unaware-CDA mothers also reported more child anxiety and depression, withdrawn behavior, aggressive behavior, and sleep problems than 440 mothers aware of their child's CDA status (all s ≤.04). At 4.5 years, there were no differences. 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.
AbstractList	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. 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. 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 s ≤ .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 s ≤.04). At 4.5 years, there were no differences. 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. 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.BACKGROUND AND OBJECTIVESPsychological 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.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.METHODSThe 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.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.RESULTSAt 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.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.CONCLUSIONSIn 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.
Author	Liu, Edwin Johnson, Suzanne Bennett Lynch, Kristian F Agardh, Daniel Kurppa, Kalle Smith, Laura B Koletzko, Sibylle Krischer, Jeffrey
Author_xml	– sequence: 1 givenname: Laura B surname: Smith fullname: Smith, Laura B organization: Diabetes Center & Health Informatics Institute, Department of Pediatrics, and – sequence: 2 givenname: Kristian F surname: Lynch fullname: Lynch, Kristian F organization: Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, Florida – sequence: 3 givenname: Kalle surname: Kurppa fullname: Kurppa, Kalle organization: Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland – sequence: 4 givenname: Sibylle surname: Koletzko fullname: Koletzko, Sibylle organization: Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany – sequence: 5 givenname: Jeffrey surname: Krischer fullname: Krischer, Jeffrey organization: Diabetes Center & Health Informatics Institute, Department of Pediatrics, and – sequence: 6 givenname: Edwin surname: Liu fullname: Liu, Edwin organization: Digestive Health Institute, University of Colorado, Children's Hospital Colorado, Denver, Colorado – sequence: 7 givenname: Suzanne Bennett surname: Johnson fullname: Johnson, Suzanne Bennett organization: Department of Medical Humanities and Social Sciences, Florida State University College of Medicine, Tallahassee, Florida; and – sequence: 8 givenname: Daniel surname: Agardh fullname: Agardh, Daniel email: daniel.agardh@med.lu.se organization: Unit of Diabetes and Celiac Disease, Malmö University, Malmö, Sweden daniel.agardh@med.lu.se
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SubjectTerms	Aggression - psychology Anxiety - etiology Autoantibodies - blood Celiac Disease - immunology Celiac Disease - psychology Child, Preschool Depression - etiology Europe Female GTP-Binding Proteins - immunology Humans Longitudinal Studies Male Mothers Prospective Studies Protein Glutamine gamma Glutamyltransferase 2 Sleep Wake Disorders - etiology Transglutaminases - immunology United States
Title	Psychological Manifestations of Celiac Disease Autoimmunity in Young Children
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