Psychological manifestations of celiac disease autoimmunity in young children

The TEDDY study group

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: Psychological symptoms can be associated with celiac disease; abstract 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. METHODS: 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. RESULTS: 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 Unaware-CDA mothers also reported more child anxiety and depression, withdrawn behavior, aggressive behavior, and sleep problems than 440 mothers aware of their child's CDA status (all Ps ≤.04).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. CONCLUSIONS: 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.

Original languageEnglish (US)
Article numbere20162848
JournalPediatrics
Volume139
Issue number3
DOIs
StatePublished - Mar 1 2017

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Celiac Disease
Autoimmunity
Psychology
Mothers
Autoantibodies
Sleep
Anxiety
Depression
Child Behavior
Checklist
Type 1 Diabetes Mellitus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Psychological manifestations of celiac disease autoimmunity in young children. / The TEDDY study group.

In: Pediatrics, Vol. 139, No. 3, e20162848, 01.03.2017.

Research output: Contribution to journalArticle

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title = "Psychological manifestations of celiac disease autoimmunity in young children",
abstract = "BACKGROUND AND OBJECTIVES: Psychological symptoms can be associated with celiac disease; abstract 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.",
author = "{The TEDDY study group} and Smith, {Laura B.} and Lynch, {Kristian F.} and Kalle Kurppa and Sibylle Koletzko and Jeffrey Krischer and Edwin Liu and Johnson, {Suzanne Bennett} and Daniel Agardh and Marian Rewers and Kimberly Bautista and Judith Baxter and Ruth Bedoy and Daniel Felipe-Morales and Frohnert, {Brigitte I.} and Patricia Gesualdo and Michelle Hoffman and Rachel Karban and Jill Norris and Adela Samper-Imaz and Andrea Steck and Kathleen Waugh and Hali Wright and Jin-Xiong She and Desmond Schatz and Diane Hopkins and Leigh Steed and Jamie Thomas and Janey Adams and Katherine Silvis and Michael Haller and Melissa Gardiner and McIndoe, {Richard A} and Sharma, {Ashok Kumar} and Joshua Williams and Gabriela Young and Anderson, {Stephen W.} and Laura Jacobsen and Ziegler, {Anette G.} and Andreas Beyerlein and Ezio Bonifacio and Michael Hummel and Sandra Hummel and Kristina Foterek and Nicole Janz and Mathilde Kersting and Annette Knopff and Claudia Peplow and Roswith Roth and Marlon Scholz and Joanna Stock",
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AU - Smith, Laura B.

AU - Lynch, Kristian F.

AU - Kurppa, Kalle

AU - Koletzko, Sibylle

AU - Krischer, Jeffrey

AU - Liu, Edwin

AU - Johnson, Suzanne Bennett

AU - Agardh, Daniel

AU - Rewers, Marian

AU - Bautista, Kimberly

AU - Baxter, Judith

AU - Bedoy, Ruth

AU - Felipe-Morales, Daniel

AU - Frohnert, Brigitte I.

AU - Gesualdo, Patricia

AU - Hoffman, Michelle

AU - Karban, Rachel

AU - Norris, Jill

AU - Samper-Imaz, Adela

AU - Steck, Andrea

AU - Waugh, Kathleen

AU - Wright, Hali

AU - She, Jin-Xiong

AU - Schatz, Desmond

AU - Hopkins, Diane

AU - Steed, Leigh

AU - Thomas, Jamie

AU - Adams, Janey

AU - Silvis, Katherine

AU - Haller, Michael

AU - Gardiner, Melissa

AU - McIndoe, Richard A

AU - Sharma, Ashok Kumar

AU - Williams, Joshua

AU - Young, Gabriela

AU - Anderson, Stephen W.

AU - Jacobsen, Laura

AU - Ziegler, Anette G.

AU - Beyerlein, Andreas

AU - Bonifacio, Ezio

AU - Hummel, Michael

AU - Hummel, Sandra

AU - Foterek, Kristina

AU - Janz, Nicole

AU - Kersting, Mathilde

AU - Knopff, Annette

AU - Peplow, Claudia

AU - Roth, Roswith

AU - Scholz, Marlon

AU - Stock, Joanna

PY - 2017/3/1

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N2 - BACKGROUND AND OBJECTIVES: Psychological symptoms can be associated with celiac disease; abstract 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

AB - BACKGROUND AND OBJECTIVES: Psychological symptoms can be associated with celiac disease; abstract 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

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DO - 10.1542/peds.2016-2848

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