Celiac.com 12/13/2024 - The study investigates whether there is a causal relationship between autoimmune diseases and schizophrenia. Schizophrenia, a severe neuropsychiatric disorder, has been associated with immune system dysfunction in prior research. However, conflicting evidence has left the nature of this connection unclear. By using advanced genetic analysis, the researchers sought to determine whether autoimmune diseases and schizophrenia directly influence each other.

Why Study Schizophrenia and Autoimmune Diseases?

Schizophrenia is a complex disorder with genetic, environmental, and biological contributors. It affects approximately 1% of the global population and significantly reduces life expectancy. Autoimmune diseases, where the immune system mistakenly attacks the body, have also been linked to schizophrenia in observational studies. However, these links could be due to overlapping genetic or environmental factors rather than direct causation. Understanding these connections could pave the way for improved prevention and treatment strategies for both conditions.

Study Design: Using Genetics to Uncover Causality

This research used Mendelian randomization, a statistical method that analyzes genetic data to infer causality between factors. By examining genetic variations associated with both schizophrenia and 10 common autoimmune diseases, the study aimed to identify whether there are direct effects between the two. These diseases included conditions like celiac disease, lupus, type 1 diabetes, and psoriasis, among others.

The bidirectional nature of the analysis meant that researchers looked at whether autoimmune diseases influenced schizophrenia and vice versa. A variety of statistical approaches were used to ensure robust results and account for confounding factors.

Key Findings

The study found distinct patterns in how schizophrenia and autoimmune diseases are linked:

1. Autoimmune Diseases Increasing Schizophrenia Risk:
   Ankylosing Spondylitis: Genetic predisposition to this inflammatory arthritis was associated with a higher risk of developing schizophrenia.
2. Autoimmune Diseases Decreasing Schizophrenia Risk:
   Celiac Disease, Type 1 Diabetes, and Lupus: Genetic markers for these conditions were linked to a lower risk of schizophrenia, challenging prior studies that suggested an increased risk.
3. Schizophrenia Increasing Autoimmune Disease Risk:
   Schizophrenia was found to heighten the risk of certain autoimmune diseases, including inflammatory bowel disease (encompassing Crohn’s disease and ulcerative colitis) and psoriasis.
4. No Causal Link Identified:
   Multiple sclerosis and rheumatoid arthritis showed no causal relationship with schizophrenia in either direction.

Exploring Biological Mechanisms

The study delved into why these links might exist. Several immune-related factors could explain the relationship:

• Immune Dysregulation: Schizophrenia and autoimmune diseases share immune system irregularities, such as imbalances in certain immune cells and altered cytokine levels.
• Genetic Overlap: Some genetic regions associated with schizophrenia also contribute to autoimmune diseases, suggesting shared pathways in their development.
• Inflammatory Triggers: Chronic inflammation and infections might simultaneously predispose individuals to both schizophrenia and autoimmune diseases.
• Antibodies and Neural Impact: In conditions like celiac disease, antibodies produced in response to gluten have been implicated in psychiatric symptoms, possibly linking immune responses to brain function.

Study Strengths and Limitations

This study was the first to use a large-scale genetic approach to comprehensively assess the relationship between schizophrenia and autoimmune diseases. By relying on genetic data, it avoided biases often present in observational studies. Sensitivity analyses further validated the results.

However, the study had limitations:

• The genetic data came exclusively from individuals of European ancestry, so findings may not apply to other populations.
• It only included 10 autoimmune diseases, leaving the potential for overlooked associations with other conditions.
• Nonlinear relationships and environmental factors, such as stress or diet, were not accounted for.

Implications for Those With Celiac Disease

One of the most significant findings for individuals with celiac disease is the evidence suggesting a protective effect against schizophrenia. This aligns with earlier studies that found improvements in psychiatric symptoms for some schizophrenia patients who adopted a gluten-free diet. Although more research is needed, this connection underscores the potential importance of nutrition and immune health in managing mental health conditions.

Why This Matters

Understanding the links between autoimmune diseases and schizophrenia is crucial for advancing medical care. This research provides evidence of specific causal relationships, shedding light on potential shared biological mechanisms. For individuals with celiac disease, it offers reassurance that their condition may not increase—and could even reduce—their risk of schizophrenia. More broadly, the findings could inspire new treatment strategies that address the immune system to improve outcomes for those with schizophrenia.

Read more at: bmcpsychiatry.biomedcentral.com

Watch the video version of this article:

Celiac.com 07/25/2023 - Non-celiac gluten sensitivity is a gluten-related disorder that results from immune-mediated reactions in predisposed people. Non-celiac gluten sensitivity usually manifests with gastrointestinal symptoms. However, in rare cases, it might present with psychiatric symptoms that could be severe enough to impair functioning. 

We've done a number of articles on the psychological and psychiatric manifestations of celiac disease, which can include, anxiety, depression, and eating disorders. There are also studies linked celiac disease to neurological manifestations, along with schizophrenia. 

Every so often, we cover a case study that may be relevant to celiac disease, in general. Our latest case involves a 15-year-old Sudanese girl, with no prior psychiatric history, who visited the emergency department due to anxiety, behavioral changes, and hallucinations of her deceased father. 

Girl Treated for Psychosis and Delusions

After witnessing her father's burial, she started experiencing flashbacks and intrusive images of him, along with anxiety about death and paranoia towards others. The patient was agitated and psychotic, requiring rapid tranquilization. She was later diagnosed with hyperthyroidism due to Grave's disease.

A team of clinicians, including Olfa Selmi, Banan Khalid, and Saleem Al-Nuaimi, present the girl's case report. They are variously affiliated with the Department of Psychiatry and the Mental Health Service at Hamad Medical Corporation and Hospital in Doha, Qatar.

Despite receiving appropriate thyroid medication, her psychiatric symptoms did not improve, leading to further investigations. Blood tests revealed positive anti-transglutaminase IgA antibodies, suggesting possible celiac disease. 

Psychosis Improves on a Gluten-Free Diet

A gastroscopy showed mild duodenal changes, and she began a gluten-free diet. Within weeks of starting the gluten-free diet, the patient's psychotic symptoms improved significantly. Whenever she consumed gluten in large quantities, her delusions resurged, and they subsided again with a return to the gluten-free diet.

The case suggests a potential link between gluten and psychosis, although the exact mechanism remains uncertain. Prior case reports also show improvements in psychotic symptoms after adopting a gluten-free diet in patients with gluten allergies or sensitivities. As a gluten-free diet is safe and low-cost, it may be considered as part of the treatment plan for reducing psychotic symptoms in patients with gluten-related disorders or autoimmune diseases. 

This case adds to the growing literature exploring the role of gluten in atypical psychotic presentations and the potential benefits of a gluten-free diet in such cases. It also highlights the importance of considering nonconventional treatments when standard therapeutic interventions do not yield satisfactory results, as aggressive treatments may carry higher risks. 

The significant improvement of the girl's psychosis upon starting on a strict gluten-free diet suggests a potential connection between gluten ingestion and psychiatric disorders. However, further research is needed to better understand the relationship between gluten and psychiatric symptoms, and to guide the use of a gluten-free diet in appropriate cases.

Read more at Cureus 15(7): e41807.

 

Celiac.com 07/06/2022 - More and more people are avoiding gluten and FODMAP food components (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) over concerns about their potential connection to celiac-like reactions in the gut. 

In recent years, gluten-free diets (GFD) and low-FODMAP diets (LFD) have become more popular across the globe. This is due to intolerances or allergies in some people, but also due to the direct influence of marketing movements or diet trends on eating choices. 

At the same time, understanding, diagnosing and treating neurological and psychiatric diseases is becoming more important in numerous countries. A number of researchers have started to examine FODMAPs for that reason. 

Because of this, the research team conducted a bibliographic systematic review to see if there is a pathophysiological relationship between consumption of gluten or FODMAPs and mental disorders. 

The research team included Egoitz Aranburu; Silvia Matias; Edurne Simón; Idoia Larretxi; Olaia Martínez; María Ángeles Bustamante; María del Pilar Fernández-Gil; and Jonatan Miranda.

They are variously affiliated with the Gluten Analysis Laboratory of the University of the Basque Country, Department of Nutrition and Food Science, University of the Basque Country in Vitoria, Spain; the GLUTEN3S Research Group, Department of Nutrition and Food Science, University of the Basque Country in Vitoria, Spain; the Bioaraba, Nutrición y Seguridad Alimentaria, in Vitoria, Spain; and the Centro Integral de Atención a Mayores San Prudencio in Vitoria-Gasteiz, Spain.

The team's review gathered data from clinical and randomized controlled trials, based on the PRISMA statement, published since 2012. 

Their analysis found that limiting or ruling out gluten or FODMAPs may improve symptoms such as depression, anxiety, or cognition deficiency, and to a lesser extent for schizophrenia and the autism spectrum. 

Nevertheless, further studies are needed to obtain completely reliable conclusions.

Read more in Nutrients 2021, 13(6), 1894.
 

Celiac.com 06/27/2022 - Consumer gluten-free diet and sales of gluten-free products have increased immensely over the last decade, fueled in part by allergies and sensitivities in some, and by the popular perception that the diet is healthier by many others. The popularity of the gluten-free diet has led a group of researchers to explore the physical and mental effects that gluten might have on young people, especially in those with existing stomach and gut issues.

The research team set out to assess the effects of gluten in adolescents and young adults with existing gastrointestinal symptoms and enrolled nearly 275 eligible adolescents, with at least four different gastrointestinal symptoms, from a population-based cohort of nearly thirteen-hundred.

In phase one of the study, fifty-four participants lived gluten-free for 2 weeks. Thirty-three participants who improved during phase one then moved to phase two.

Phase two was a blinded randomized cross-over trial, in which participants were blindly randomized either to start with 7 days of gluten, eating two granola bars containing 10g of gluten or to 7 days on placebo, eating two granola bars without gluten, followed by the reverse and separated by a 7-day washout period. 

The team measured any effects of the intervention on gastrointestinal symptoms and participant mental health.

Overall, just under sixty of the 273 participants entered the run-in phase, with 35 eligible for randomization. A total of 33 were randomized, while 32 completed the trial. Average age was just over 20 years old, and nearly all participants were women. 

The team found that, compared with placebo, adding gluten to the diet did not trigger gastrointestinal symptoms or negatively affect mental health in adolescents who participated in this trial. 

Read more in Alimentary Pharmacology & Therapeutics 29 March 2022
 

The research team included Caecilie Crawley, Nadia Savino, Cecilie Halby, Stine Dydensborg Sander, Anne-Marie Nybo Andersen, Manimozhiyan Arumugam, Joseph Murray, Robin Christensen, and Steffen Husby. They are variously affiliated with the Hans Christian Andersen Children’s Hospital, Odense University Hospital, Odense, Denmark; the Department of Clinical Research, University of Southern Denmark, Odense, Denmark; the Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; the  Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; the Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark; the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA; the Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; the Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark.

Celiac.com 03/21/2022 - Eating a gluten-free diet is the only current treatment for celiac disease, but managing that diet can be difficult. It can come with a substantial perceived treatment burden, and is tied to higher rates of psychopathology in adult patients.

Some studies have identified psychological problems in children with celiac disease, but no systematic review has documented actual rates. However, it is still important to determine the risk for psychological comorbidities in children with celiac disease before they become adults. 

A team of researchers recently set out to review existing research on mental health issues in children with celiac disease, and to compile a psychosocial research and clinical agenda. The research team included Shayna Skelley Coburn, Elaine Leonard Puppa, and Samra Blanchard. They are variously affiliated with the Department of Gastroenterology, Children's National Health System; the George Washington University School of Medicine, Washington, DC; and the University of Maryland Medical Center, Baltimore, MD.

The team researched a number of databases, including Scopus and PubMed, and followed up any relevant references to additional publication material. 

Two investigators screened studies for preset factors. They looked for electronically available peer-reviewed celiac studies, published in English, that included children. One investigator pulled the data, which the second investigator then reviewed.

The team found twenty-six publications which met their criteria, including 16 case-control, 9 observational, and 1 clinical trial. Source materials differed in terms of symptoms examined, methodology, and population characteristics. 

A number of studies found that kids with celiac disease had an elevated risk for psychological comorbidities, along with poorer quality of life scores. However, a large number of studies were limited by small sample size, and inconsistent or non-validated methods of measuring psychological symptoms.

Because numerous prior studies have shown increased rates of celiac disease coupled with psychological symptoms or diagnoses, the team stresses the need for screening for psychological issues in celiac patients, and also for celiac screening in psychological patients.

Further study of the issue is also clearly warranted. By identifying the need for evidence-based recommendations for psychosocial research and practice in children with celiac disease, the team is setting the stage for better overall care and quality of life for people with celiac disease.

Read more in Nutrients

Celiac.com 01/10/2022 - People with celiac disease technically suffer from a T cell-mediated, tissue-specific autoimmune disease, which affects genetically susceptible individuals who eat certain proteins contained in wheat, rye, or barley. 

A team of researchers recently set out to show the various neurological and psychiatric symptoms in celiac disease. The research team included Giovanna Campagna, Mirko Pesce, Raffaella Tatangelo, Alessia Rizzuto, Irene La Fratta, and Alfredo Grilli. They are affiliated with the Medicine and Health Science School, Università “G. d’Annunzio”, in Chieti, Italy.

Individual patient genetics, environmental factors, and different immune systems, together with auto-antigens, all factor into the pathogenesis of celiac disease.  The pathogenesis of celiac disease is connected with immune dysregulation, which involves the gastrointestinal system, and the extra-intestinal systems such as the nervous system, whose neurological symptoms are evidenced in celiac patients. 

A gluten-free diet (GFD) could help celiac patients to avoid cerebellar ataxia, epilepsy, neuropathies, migraine and mild cognitive impairment. 

Moreover, celiac patients on a gluten-free diet have fewer symptoms and psychiatric co-morbidities than untreated celiac patients, including depression, apathy, anxiety, irritability and schizophrenia, which are common in untreated celiac patients. 

A number of studies show a reduction in psychiatric symptoms in patients who start a gluten-free diet. The research team offers a review and discussion of the state of the art regarding neurological and psychiatric complications in celiac disease.

In addition to highlighting data that suggest a gluten-free diet can help to reduce neurological and psychiatric complications. The researchers conclude:

Quote

While some of these symptoms can improve with a gluten-free diet, our advice is to try to diagnose celiac disease as early as possible, given that delays in the diagnosis may cause severe implications in the nervous system. The importance of early diagnosis is fundamental and the only treatment available is a gluten-free diet to be followed for a lifetime.

This is neither the first nor the last study to support the idea that a gluten-free diet can help people with celiac disease to reduce neurological and psychiatric complications. Stay tuned for more on this and related stories.

Read more at Cambridge University Press

Celiac.com 02/15/2021 - A number of studies have tied celiac disease to psychiatric disorders, but there is still not much good data to support the connection. To get a better picture of the issue, a team of researchers recently set out to describe the epidemiology of several psychiatric disorders in celiac disease.

The research team included Motasem Alkhayyat, Thabet Qapaja, Manik Aggarwal, Ashraf Almomani,  Mohammad Abureesh, Omaymah Al‐otoom, Mohammad Zmaili, Emad Mansoor, and Mohannad Abou Saleh.

They are variously affiliated with the Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Cleveland, Ohio; the Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio; the Department of Gastroenterology, University Hospitals Cleveland Medical Center, Cleveland, Ohio; the Department of Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio; University of Jordan Medical School, University of Jordan, Amman, Jordan; and Department of Internal Medicine, Staten Island University Hospital, New York City, New York.

For their study, the team used a multi‐center database, called Explorys Inc, which offers electronic health record data from 26 major integrated healthcare systems consisting of 360 hospitals in the US. Of the 3,746,581 patients in the database between 2016‐2020, there were 112,340 patients with celiac disease. 

The team identified a group with celiac disease using the Systematized Nomenclature Of Medicine ‐ Clinical Terms (SNOMED–CT). They then conducted multivariate analysis using SPSS version 25. 

Compared to patients with no history of celiac disease, celiac patients were more likely to have a history of anxiety, depression, bipolar, ADHD, eating disorder, and autistic disorder. Patients with celiac disease and psychiatric conditions were more likely to be smokers, and to have a history of alcohol and substance abuse , along with a history of personality disorder.

This large database study shows that celiac patients have a higher risk of having multiple psychiatric diseases including anxiety, depression, bipolar, ADHD, eating disorder, and autism. 

The team advises clinicians to keep mental health in mind when treating celiac patients, and to make psychiatric referrals as needed.

Read more in Gastroenterology

Celiac.com 01/27/2021 - The effects of celiac disease are typically gastrointestinal, though there have been rare cases where celiac disease can manifest with psychiatric symptoms and behavioral disturbances.

In one recent case, a woman with untreated celiac disease experienced psychotic delusions when eating gluten. The delusions left her isolated from family and friends, and led to psychiatric treatment, diagnosis of celiac disease, and adoption of a gluten-free diet. After improving, accidental gluten consumption caused another break that led to a homicide attempt on her parents.

In an unrelated matter, a team of researchers recently reported on the case of a 25-year-old man with a history of schizophrenia and autism spectrum disorder who was seen for behavioral disturbance after breaking into a neighboring house to eat food. 

The research team included Andrew K. Murphy, Joseph A. Norton, and Benjamin R. Pflederer. They are affiliated with the Department of Medicine at the University of Illinois College of Medicine in Peoria, Illinois.

The male patient reported several months of diarrhea and fecal incontinence, and was severely malnourished on exam, despite eating sufficient food. 

These days, with better celiac awareness and testing, it's uncommon for patients to present with celiac crisis, which is marked by profuse diarrhea and severe metabolic/nutritional disturbances. 

Interestingly, behavioral disturbances, such as increased aggression or anxiety, are often the main manifestation of celiac disease in children, with gastrointestinal symptoms being milder or absent.

A blood screen showed high tissue transglutaminase IgA antibody (TTG) and gliadin IgA levels, and celiac disease was confirmed by biopsy. 

The patient began a lactose-free and gluten-free diet, and received a short course of total parenteral nutrition (TPN) for nutritional resuscitation. He improved rapidly with this treatment, and his nutrition and behavior returned to baseline.

This report of a case in which an adult with psychiatric comorbidities manifesting mainly as behavioral disturbances more common in children. 

Such patients can show highly atypical symptoms, and clinicians should watch carefully for such cases.

Read more at: Am J Case Rep 2020; 21:e928337

Celiac.com 01/19/2021 - Typically, when people with celiac disease eat gluten, they experience gastrointestinal discomfort, or even symptoms like a skin rash, anemia, and headaches. In some extreme cases, though, the side effects could be much, much worse. But, in rare cases, celiac disease can manifest with psychiatric symptoms and behavioral disturbances. Interestingly, celiac disease in children often manifests mainly as behavioral disturbance, such as increased aggression or anxiety, with milder or absent gastrointestinal symptoms. That was the case with a 37-year-old, successful PhD student, from Massachusetts. 

Woman Begins to Have Delusions

The woman began experience severe unexplained hallucinations, paranoia. She became convinced that everyone she knew were conspiring against her, and that friends, family members and even strangers were acting out pre-scripted scenes in some kind of a “game.” Her dissociation from reality became so severe that she alarmed those around her, and they sought to get her help.

Doctors Suspect Psychotic Disorder

The woman was admitted to a psychiatric hospital, where doctors diagnosed a psychotic disorder, and prescribed powerful antipsychotic drugs in order to control her symptoms. However, the drugs had practically no effect.

On follow-up, the doctors found the woman suffered from numerous mineral and vitamin deficiencies, along with thyroid problems. She had also lost a substantial amount of weight. Eventually, they screened her for celiac disease, and discovered that she had it.

Doctors Confirm Gluten Causing Woman's Delusions

Once the doctors confirmed celiac disease, they advised the woman to avoid gluten, and eat a standard gluten-free diet. 

However, the woman's delusions had not subsided, and she regarded the doctors as just another part of  the conspiracy of people working against her. This belief led her to completely disregarded the gluten-free diet.

Sadly, the woman's condition spiraled out of control, and she soon lost her job, her home, and became alienated from her family and friends.

After becoming homeless and desperate, the woman unsuccessfully attempted suicide. Fortunately, she was returned to the hospital, where she began to embrace a gluten-free diet.

Return to Normal on a Gluten-Free Diet

According to Dr. Alessio Fasano, Director of the Center for Celiac Research and Treatment at Massachusetts General Hospital, the woman's condition improved quickly. In no time, she was able to think clearly, and to understand that gluten had been causing her to have serious mental problems. The woman was remorseful, and apologetic for causing so much trouble.

Eating Gluten Leads to Murder Attempt

The woman began to follow her prescribed diet, but, after accidentally eating gluten, her psychosis returned, and she attempted to kill her parents. Thankfully, she did not succeed, but she was arrested, tried, and sent to prison.

The woman's case proves that, in rare cases, celiac disease can cause severe psychotic and other behavioral symptoms.

The Link Between Gluten and Psychosis

Researchers don't have much good information on the connection between gluten disease and mental disorders. Dr. Fasano suspects a connection lies in the human immune system.

When people with celiac disease eat gluten, they typically experience inflammation of the gut. Dr. Fasano believes that, in some cases, such as with the woman in question, gluten-triggered inflammation moves beyond the gut to the brain, which could explain the kind of psychotic delusions experienced by the woman.

A better understanding of the connection between gluten and psychosis in such cases could help improve the treatment of celiac disease and gluten sensitivity. 

Until then, cases such as this are a reminder of just how much we don't know, and how much further we have to go in learning about and treating celiac disease in all its manifestations. 

Read more at oddee.com and  nejm.org

Celiac.com 08/25/2020 - A number of studies describe psychological disorders, in addition to other extra intestinal manifestations of celiac disease, such as fatigue, neurological conditions including headache and neuropathy. However,  there hasn't been study with robust enough data to provide accurate risk estimates.

In an effort to obtain accurate risk estimates, Jonas F. Ludvigsson, MD, PhD, of the department of medical epidemiology and biostatistics at Karolinska Institutet in Sweden, and colleagues analyzed data from the Swedish nationwide ESPRESSO cohort to explore associations between childhood celiac disease and psychiatric disorders. 

They matched nearly 20,000 children with biopsy verified celiac with up to five of 100,000 reference children, and gathered data on psychiatric disorders from the patient register.

During a follow-up period of just over 12 years, nearly 17% of 3,174 children with celiac disease were diagnosed with a psychiatric disorder, compared with about 14% of the 13,286 control subjects. People with childhood celiac disease had a nearly 20% increase in risk for any psychiatric disorder, an increase seen in every childhood age group. 

Specifically, celiac patients faced elevated risks for mood disorders, anxiety disorders, eating disorders, attention deficit hyperactivity disorder, autism spectrum disorder, and increased use of psychiatric drugs. The risk was highest in the first year after celiac diagnosis, but continued into adulthood.

The results of this study underline the importance of mental health monitoring in people diagnosed with celiac disease as children. Because of the elevated risk of psychiatric disorder, the team advises that people diagnosed with celiac disease in childhood receive both physical and mental monitoring into adulthood.

Stay tuned for more on this and related stories. 

Read more at Healio.com.

Celiac.com 09/17/2019 - Celiac disease is associated with psychopathology in children. However, it's unknown whether this connection is present in children with celiac disease autoimmunity identified by screening.

A team of researchers recently set out to examine the associations between sub-clinical celiac disease autoimmunity and emotional and behavioral problems in children without a previous celiac disease diagnosis.

The research team included Rama J. Wahab, Sytske A. Beth, Ivonne P.M. Derks, Pauline W. Jansen, Henriëtte A. Moll, and Jessica C. Kiefte-de Jong.

As part of a population-based cohort study, the team analyzed levels of tissue transglutaminase autoantibodies in 3,715 children averaging 6 years of age. After excluding children with diagnosed celiac disease or those on a gluten-free diet, the team found 51 children with celiac disease autoimmunity, defined as levels of tissue transglutaminase autoantibodies at or above 7 U/mL. 

To assess behavioral and emotional problems of children averaging 5.9 years old, they used a Child Behavior Checklist (CBCL) completed by the parents. They applied multiple linear regression models to assess the cross-sectional connections between celiac disease autoimmunity and CBCL scores. They also conducted sensitivity analyses in a subgroup of seropositive children with HLA antigen risk alleles for celiac disease.

The data showed that celiac disease autoimmunity, especially combined with the HLA-DQ2 and HLA-DQ8 risk alleles, is associated with anxiety problems and oppositional defiant problems. 

The team is calling for more research to determine whether behavioral problems might be an indication of sub-clinical celiac disease.

Read more in Pediatrics

The researchers are variously affiliated with the Generation R Study Group; the Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands; the Departments of Child and Adolescent Psychiatry and Psychology; the Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands; and the Department of Public Health and Primary Care, Campus The Hague, Leiden University Medical Center, The Hague, Netherlands.

Celiac.com 08/14/2019 - One question we get often is whether a gluten-free diet can help treat bipolar disorder. There’s growing evidence that autoimmune disorders and bipolar disorder are closely connected. 

It's also true that celiac disease and bipolar disorder are linked. People with celiac disease are many times more likely to have bipolar disorder than those without celiac.

About 1% of the population has celiac disease. However, nearly 4.3% of celiacs are diagnosed with bipolar disorder, compared a 0.4% bipolar rate for the non-celiac control group.

Having a mood disorder can have a major negative impact on quality of life in people with celiac disease. One study suggests that the negative impact on quality of life in people with celiac disease and bipolar disorder is second only to that of people with bipolar and MS.

While there's been some study connecting gluten sensitivity and acute mania, there really hasn't been much research on a gluten-free diet for people with bipolar disorder. That means much of the information is anecdotal, and needs to be taken with a grain of salt.

The topic thread on the Celiac.com forum contains robust commentary on the gluten-free diet and bipolar disorder.

In his blog, Getting Older With Bipolar, George Hofmann shares his own experiences on being bipolar with celiac disease, and the benefits of a gluten-free diet.

On going gluten-free, Hofmann says "I had gut problems for decades.  I thought it was normal to feel like crap after I ate.  Then I was diagnosed with celiac disease and my life completely changed. Please understand, though, that my bipolar disorder is still medically treated as it was before I knew I had celiac disease.  Removing gluten from my diet has not led to the removal of my psych meds...My bipolar disorder is not cured.  I just feel a lot better."

Celiac disease increases immune activation, which many researchers think is an important factor in the onset of bipolar disorder.

Many researchers suggest celiac disease screening for people with bipolar disorder who show some key symptoms or have a family history of celiac disease. Many of those same researchers suggest screening people with celiac disease for a mood disorders.

To close, the current answer to the question whether a gluten-free diet can help treat bipolar disorder would be that there's a good amount of anecdotal evidence that a gluten-free diet can help to improve the general well-being of people with bipolar and other mood disorders.

However, there's not much in the way of actual science to support those claims. Still, for people with bipolar disorder, there's likely not much of a downside to following a gluten-free diet, as long make sure you get adequate nutrition and fiber. As always, check with your doctor before adopting any treatment or change that may have an influence on your condition of symptoms. Also, consider getting tested for celiac disease.

Read more at NIH