Psychopathology, quality of life, and related factors in children with celiac disease☆

Sevinç, Eylem; Çetin, Fatih Hilmi; Coşkun, Banu Demet

doi:10.1016/j.jped.2016.06.012

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Original articles • J. Pediatr. (Rio J.) 93 (3) • May-Jun 2017 • https://doi.org/10.1016/j.jped.2016.06.012 copy

Psychopathology, quality of life, and related factors in children with celiac disease^☆ ☆ Please cite this article as: Sevinç E, Çetin FH, Coşkun BD. Psychopathology, quality of life, and related factors in children with celiac disease. J Pediatr (Rio J). 2017;93:267-73.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

This study aimed to survey children with celiac disease (CD) for psychiatric disorders, determine the possible factors that predict psychopathology, and analyze health-related quality of life and possible factors that could affect the quality of life.

Methods:

In this study, all children completed the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime Version - Turkish Version (K-SADS-PL-T), as well as the Pediatric Quality of Life Inventory (PedsQL) for the 8-12 age group, and a sentence completion test. A face-to-face interview was performed with the parents of the participants to inform them about the study.

Results:

This study included 52 children with celiac disease in the age range of 8-12 years, and 40 healthy children. The mean age of the study group was 10.36 ± 0.36 years, and 31 (59%) of them were females. The mean age of the control group was 10.35 ± 0.46 years and 24 (60%) of them were females. The mean subscale scores of the Pediatric Quality of Life Inventory were significantly lower in children with celiac disease when compared to the control group (p < 0.05). There was at least one psychiatric disorder in the 26 (50%) children with celiac disease.

Conclusions:

This study has shown once more that celiac disease is associated with some psychiatric signs/diagnoses, and that it decreased quality of life. Further studies are needed to determine the factors that could reduce the psychiatric signs. It is apparent that those studies would contribute new approaches to improve diagnosis, treatment, and quality of life.

KEYWORDS
Celiac disease; Quality of life; Child; Psychiatric diagnosis

	Study group (n = 52)	Control group (n = 40)	p
Age (years) (mean ± SD,^a a Standard deviation. min-max)	10.36 ± 0.36 (8-12)	10.35 ± 0.46 (8-12)	0.700
Gender (Female/male, %)	31/21 (59%/41%)	24/16 (60%/40%)	0.650
Household members (mean ± SD)	4.66 ± 1.22	4.46 ± 0.97	0.088
Height (cm; mean ± SD)	129.50 ± 8.67	134.42 ± 7.89	0.176
Weight (kg; mean ± SD)	27.05 ± 8.85	33.57 ± 8.22	0.491
BMI (kg/m²; mean ± SD)	16.02 ± 1.07	16.95 ± 1.14	0.627
Age at first diagnosis (years; mean ± SD)	6.4 ± 2.2
Duration of follow up (years; mean ± SD)	3.94 ± 1.10

Adherence to gluten-free diet (n,%) ^b b Good adherence to diet: the patients with a serum endomysium antibody (EMA) level <20 RU/mL.
Good adherence	16 (30%)	-
Poor adherence	36 (70%)

Socioeconomic level (n,%)
Low	10 (19%)	8 (20%)	0.79
Moderate	37 (82%)	28 (70%)
High	5 (9%)	4 (10%)

Parent education (maternal-paternal, n, %)
Elementary school	8 (16%)-7 (13%)	6 (15%)-6 (15%)	0.842^c c There were no significant differences between the celiac group and controls for maternal education status.
Middle school	35 (67%)-28 (53%)	25 (62%)-24 (60%)	0.322^d d There were no significant differences between the celiac group and controls for paternal education status.
High school	9 (17%)-17 (34%)	9 (23%)-10 (25%)

	Study group (n = 52)	Control group (n = 40)	p
EFS	82.5 (0-100)^a a Median (min-max).	90 (0-100)^a a Median (min-max).	0.003
SoFS	97.5 (50-100)^a a Median (min-max).	90 (70-100)^a a Median (min-max).	0.024
ScFS	90 (45-100)^a a Median (min-max).	100 (80-100)^a a Median (min-max).	0.000
TPhHS	79.68 (34.37-100)^a a Median (min-max).	100 (75-100)^a a Median (min-max).	0.005
TPsHS	90 (41.65-100)^a a Median (min-max).	90 (76.66-100)^a a Median (min-max).	0.039
TSS	87.50 (44.56-100)^a a Median (min-max).	92.30 (84.78-100)^a a Median (min-max).	0.000

	EFS	SoFS	ScFS	TPhHS	TPsHS	TSS
Psychiatric diagnosis
Present	85	100	90	75	90.8	85.4
Absent	75	95	87.50	84.30	86.81	84.7
p	0.519	0.206	0.514	0.755	0.433	0.219

Gender
Male	85	100	95	87.5	90	90.12
Female	75	95	90	75	88.3	83.69
p	0.040^a a p < 0.05.	0.897	0.488	0.032^a a p < 0.05.	0.167	0.107

Adherence to gluten-free diet ^b b Good adherence to diet: patients with a serum endomysium antibody (EMA) level <20 RU/mL.
Good adherence	72.5	95	87.5	70.3	85	80.43
Poor adherence	85	100	90	84.3	90.8	85.80
p	0.414	0.464	0.425	0.052	0.433	0.219

Socioeconomic level
Low	87.5	100	92.5	78.12	92.49	84.85
Moderate	80	95	90	83.5	90	84.7
High	70	100	90	84.37	85	83.69
p	0.650	0.137	0.951	0.703	0.763	0.979

Duration of disease ^c c Spearman's correlation analysis.
r	−0.249	0.036	−0.300	−0.362	−0.240	−0.313
p	0.755	0.798	0.031^a a p < 0.05.	0.008^a a p < 0.05.	0.875	0.025^a a p < 0.05.

	Presence of a psychiatric diagnosis (n = 26)	Absence of a psychiatric diagnosis (n = 26)	p
Gender (n)
Male	11	10	0.780
Female	15	16	0.780

Adherence to gluten-free diet (n) ^a a Good adherence to diet: patients with a serum endomysium antibody (EMA) level <20 RU/mL.
Good adherence	7	9	0.535
Poor adherence	19	17	0.535

Socioeconomic level (n)
Low	7	3	0.290
Moderate	16	21
High	3	2

Duration of disease ^b b Spearman's correlation analysis.
1-3 years	14	16	0.800
4-7 years	12	10	0.800

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[1] * Corresponding author. E-mail:dr.eylemsevinc@gmail.com (E. Sevinç).

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Psychopathology, quality of life, and related factors in children with celiac disease☆ ☆ Please cite this article as: Sevinç E, Çetin FH, Coşkun BD. Psychopathology, quality of life, and related factors in children with celiac disease. J Pediatr (Rio J). 2017;93:267-73.

Abstract

Objective:

Methods:

Results:

Conclusions:

Psychopathology, quality of life, and related factors in children with celiac disease^☆ ☆ Please cite this article as: Sevinç E, Çetin FH, Coşkun BD. Psychopathology, quality of life, and related factors in children with celiac disease. J Pediatr (Rio J). 2017;93:267-73.