Comparasion of Psychiatric Features and Family Functioning in Adolescents with Celiac and Healthy Adolescents

Abstract

Objective: Celiac disease (CD); is a small intestinal disease that occurs in congenital predisposing individuals at any age. Psychiatric problems may be more prevalant in celiac patients. The aim of this study is to compare psychiatric problems and family functioning through controls in patients with celiac disease and to analyze the relation between these data and adherence to celiac diet.

Material and Methods: A total of 35 adolescent patients aged between 12 and 18 years who were followed up with the diagnosis of celiac disease were included in the study. Patients' age, diagnosis symptoms, Marsh stages were recorded. Height and weight measurements were made in the outpatient clinic and celiac serology test was taken.47 patients who were referred to our pediatric outpatient clinics without known chronic disease were taken as a control. Beck depression inventory, strength difficulties questionnaire, family assessment device were performed.

Results: When study and control groups were compared through beck depression inventory, those with celiac disease had statistically significantly higher scores than healthy control group. It was found that adolescents diagnosed with celiac suffer from more difficulties in emotional and social areas when study and control groups were compared through strengths and difficulties questionnaire.

Conclusion: Psychiatric problems and depression are often more common in children with CD than without CD, and contribute to a decline in quality of life. For this reason, psychosocial support may be important in treatment of celiac. 

Keywords

• Adolescents,Celiac Disease

Sağlıklı ve Çölyak Hastalığı Tanısı ile İzlenen Adölesanlarda Psikiyatrik Özellikler ve Aile İşlevselliğinin Karşılaştırılması

Abstract

Amaç: Çölyak hastalığı; konjenital olarak yatkın bireylerde her yaşta ortaya çıkabilen bir ince bağırsak hastalığıdır. Çölyak hastalarında psikiyatrik sorunlar sağlıklı bireylere kıyasla daha yaygın olabilir. Bu çalışmanın amacı çölyak hastalığı olan hastalarda psikiyatrik sorunları ve aile işlevini kontrol etmek ve bu verilerle çölyak diyetine uyum ile arasındaki ilişkiyi incelemektir.

Gereç ve Yöntemler: Çalışmaya Çölyak hastalığı tanısıyla takip edilen 12-18 yaş arası toplam 35 adölesan hasta alınmıştır. Hastaların yaşı, tanı semptomları, Marsh evreleri kaydedildi. Poliklinikte boy ve kilo ölçümleri yapılıp, çölyak seroloji testi alınmıştır. Hastanemiz pediatri polikliniklerine başvuran ve bilinen kronik hastalığı olmayan 47 olgu da kontrol olarak alınmıştır. Hastalara çocuk psikiyatri hekimi tarafından Beck depresyon ölçeği, güçler güçlükler anketi, aile değerlendirme ölçeği yapıldı.

Sonuçlar: Çalışma ve kontrol grupları beck depresyon ölçeğisonuçlarına göre karşılaştırıldığında, çölyak hastalığı olanlarda sağlıklı kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek puanlar elde edildi. Çölyak tanısı alan ergenlerin, çalışma ve kontrol gruplarının güçler ve güçlükler soru formları ile karşılaştırıldığı durumlarda, duygusal ve sosyal alanlarda daha fazla sıkıntı yaşadıkları saptanmıştır.

Sonuç: Çölyak Hastalığı tanısı olan çocuklarda, psikiyatrik sorunlar ve depresyon sağlıklı çocuklara göre genellikle daha sık görülür ve yaşam kalitesinde bozulmaya neden olabilir. Bu nedenle, çölyak tedavisinde psikososyal destek önemli olabilir.

Keywords

• Adölesan,Çölyak Hastalığı

References

1. Referans 1. Maki M, Mustalathi K, Kokkonen J, Kulmala P, Haapalahti M, Karttunen T, et al. Prevalence of celiac disease among children in Finland. N Engl J Med 2003; 19: 2517-24.
2. Referans 2. Dalgic B, Sari S, Basturk B, Ensari A, Egritas O, Bukulmez A, et al. Prevalence of celiac disease in healthy Turkish school children. Am J Gastroenterol 2011; 106: 1512-7.
3. Referans 3.Almallouhi E, King KS, Patel B, Wi C, Juhn YJ, Murray JA, Absah I. Increasing incidence and altered presentation in a population-based study of pediatric celiac disease in North America. J Pediatr Gastroenterol Nutr 2017; 65: 432–437.
4. Referans 4.Csizmadia CG, Mearin ML, von Blomberg BME, Brand R, Verloove-Vanhorick SP. An iceberg of childhood coeliac disease in the Netherlands. Lancet 1999; 353: 813–814.
5. Referans 5. Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA; American College of Gastroenterology. ACG clinical guidelines: diagnosis and management of celiac disease. Am J Gastroenterol 2013; 108: 656-76.
6. Referans 6. Aydogdu S, Midyat L, Cakir M, Tumgor, Yuksekkaya HA, Baran M, et al. Long-term effect of gluten-free diet on growth velocity in Turkish children with celiac disease. Dig Dis Sci 2009; 54: 2183-7.
7. Referans 7. Fabiana Z, Gillian LS, Timothy RC, David SS, Jonas FL, Julio CB. Psychological morbidity of celiac disease: A review of the literatureUnited European Gastroenterology Journal 2015; 3: 136–145.
8. Referans 8. Hernanz A, Polanco I. Plasma precursor amino acids of central nervous system, monoamines in children with coeliac disease. Gut. 1991; 32: 1478-81.

9. Referans 9. Beck AT, Ward C, Mendelson M. Beck depression inventory (BDI). Arch Gen Psychiatry 1961; 4: 561-71.
10. Referans 10. Hisli-Sahin N. A study on the validity of Beck Depression Inventory. Turkish Journal of Psychology 1988; 6: 118-126.
11. Referans 11. Goodman R. The strengths and difficulties questionnaire: A research note. JJ Child Psychol Psychiatry 1997; 38: 581-586.
12. Referans 12. Güvenir T, Özbek A, Baykara B, Arkar H, Şentürk B, İncekaş S. Psychometric Properties of The Turkish Version of The Strengths and Difficulties Questionnaire (SDQ). Turk J Child Adolesc Ment Health.2008; 15: 65-74.
13. Referans 13. Epstein NB, Baldwin LM, Bishop DS. The McMaster family assessment device. Journal of marital and family therapy, 1983; 9: 171-180.
14. Referans 14.Bulut, I. Family assessment scale handbook. Ankara: Ozguzelis Printing House,1990: p. 6-8.Referans 15. Hallert C, Astrom J and Sedvall G. Psychic disturbances in adult coeliac disease. Scand J Gastroenterol 1982; 17: 25–28.
15. Referans 16. Nachman F, del Campo MP, Gonza´ lez A, Corzo L, Vazquez H, Sfoggia C, et al. Longterm deterioration of quality of life in adult patients with celiac disease is associated with treatment noncompliance. Dig Liver Dis 2010; 42: 685–691.
16. Referans 17. Addolorato G, De Lorenzi G, Abenavoli L, Leggio L, Capristo E, Gasparrini G, et al. Psychological support counselling improves gluten-free diet compliance in coeliac patients with affective disorders. Aliment Pharmacol Ther. 2004; 20: 777–782.
17. Referans 18. Fera T, Cascio B, Angelini G, Martini S, Guidetti CS. Affective disorders and quality of life in adult coeliac disease patients on a gluten-free diet. Eur J Gastroenterol Hepatol. 2003; 15: 1287–1292.
18. Referans 19. Van Hees NJ, Van der Does W and Giltay EJ. Coeliac disease, diet adherence and depressive symptoms. J Psychosom Res 2013; 74: 155–160.
19. Referans 20. Potocki P, Hozyasz K. Psychiatric symptoms and coeliac disease. Psychiatr Pol. 2002; 36: 567-78.
20. Referans 21. Cossu G, Carta MG, Contu F, Mela Q, Demelia L, Elli L, et al. Coeliac disease and psychiatric comorbidity: epidemiology, pathophysiological mechanisms, quality-of-life, and gluten-free diet effects. I nt Rev Psychiatry. 2017; 29: 489-503.
21. Referans 22. Campagna G, Pesce M, Tatangelo R, Rizzuto A, La Fratta I, Grilli A. The progression of coeliac disease: its neurological and psychiatric implications. Nutr Res Rev. 2017; 30: 25-35.
22. Referans 23. Epifanio MS, Genna V, Vitello MG, Roccella M, La Grutta S. Parenting stress and impact of illness in parents of children with coeliac disease. Pediatr Rep. 2013; 19: 5: 19.
23. Referans 24. Mitchell AE, Fraser JA, Morawska A, Ramsbotham J, Yates P. Parenting and childhood atopic dermatitis: A cross-sectional study of relationships between parenting behaviour, skin care management, and disease severity in young children. Int J Nurs Stud. 2016; 64: 72-85.
24. Referans 25. Winders Davis D, Myers J, Logsdon MC, Bauer NS. The Relationship Among Caregiver Depressive Symptoms, Parenting Behavior, and Family-Centered Care. J Pediatr Health Care. 2016; 30: 121-32.