Evaluation of Psychopathology and Quality of Life in Children with Celiac Disease and their Parents
AbstractObjective: Celiac disease is a chronic disorder which is among common causes of malabsorption at childhood and can affect children and adults lifelong. Celiac disease negatively affects psychosocial development of children and adolescents and impairs health-related quality of life. In this study, it was aimed to assess levels of depression and anxiety in children and adolescents with Celiac disease, relationship between these parameters and quality of life in the patients and their mothers. Method : Forty children and adolescents with Celiac disease (aged 8-18 years) who were followed in Pediatric Gastroenterology Department of Erciyes University, Medicine School for at least 6 months and their mothers were included to the study. Forty age- and sex-matched subjects and their mothers were employed as control group. In all children and adolescents, it was asked to complete ‘Depression Scale for Children, State-Trait Anxiety Inventory and Pediatric Quality of Life Inventory’. All mothers were asked to complete ‘Post-traumatic Stress Disorder Scale and Quality of Life Inventory’. Results : Each group consisted of 17 males (42.5%) and 23 females (57.5%). In each groups, there are 22 (55%) individuals in the 8-12 age group and 18 (45%) individuals in the 13-18 age group. No significant difference was detected in depression scale scores between children and adolescents with Celiac disease and controls. Anxiety levels were found to be higher in pediatric age group when compared to controls while no significant difference was detected between adolescents and controls. No significant difference was detected in perception of quality of life in children and adolescents and their mothers in both groups. Post-traumatic stress level was found to be higher in mothers of children and adolescents with Celiac disease when compared to those in mothers of controls. Conclusion : There was an increase in anxiety levels in children with celiac diagnoses and an increase in trauma symptoms in their mothers and no difference in quality of life was found. It was concluded that Celiac disease affecting children and their family with many problems and impaired quality of life in children and adolescents, but many factors play role in this process.
Troncone R, Jabri B. Coeliac disease and gluten sensitivity. J Intern Med 2011; 269: 582-90.
Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, et al. Global prevalence of celiac disease: systematic review and meta-analysis. Clinical Gastroenterology and Hepatology 2018; 16:823-36.
Leonard MM, Sapone A, Catassi C, Fasano A. Celiac Disease and Nonceliac Gluten Sensitivity: A Review. Jama 2017; 318: 647-56.
Husby S, Koletzko S, Korponay-Szabo I, Mearin M, Phillips A, Shamir R, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. Journal of pediatric gastroenterology and nutrition 2012; 54: 136-60.
Siniscalchi M, Iovino P, Tortora R, Forestiero S, Somma A, Capuano L, et al. Fatigue in adult coeliac disease. Alimentary pharmacology & therapeutics 2005; 22: 489-94.
Zingone F, Swift GL, Card TR, Sanders DS, Ludvigsson JF, Bai JC. Psychological morbidity of celiac disease: A review of the literature. United European Gastroenterology Journal 2015; 3: 136-45.
Ciacci C, Iavarone A, Mazzacca G, De Rosa A. Depressive symptoms in adult coeliac disease. Scandinavian journal of gastroenterology 1998; 33: 247-50.
Ludvigsson JF, Reutfors J, Osby U, Ekbom A, Montgomery SM. Coeliac disease and risk of mood disorders-a general population-based cohort study. J Affect Disord 2007; 99: 117-26.
Karakoç MD. Çölyak hastalığı olan kadınların depresyon ve umutsuzluk düzeyleri. Endokrinolojide Diyalog 2015; 12: 41-4.
Mazzone L, Reale L, Spina M, Guarnera M, Lionetti E, Martorana S, et al. Compliant gluten-free children with celiac disease: an evaluation of psychological distress. BMC pediatrics 2011; 11: 46.
Akdemir N, Birol L. İç Hastalıkları ve Hemşirelik Bakımı. Ankara: Sistem Ofset; 2005: 193-200.
Rijken M, van Kerkhof M, Dekker J, Schellevis FG. Comorbidity of chronic diseases: effects of disease pairs on physical and mental functioning. Qual Life Res 2005; 14: 45-55.
Wagner G, Berger G, Sinnreich U, Grylli V, Schober E, Huber WD, et al. Quality of life in adolescents with treated coeliac disease: influence of compliance and age at diagnosis. J Pediatr Gastroenterol Nutr 2008; 47: 555-61.
Norstrom F, Lindholm L, Sandstrom O, Nordyke K, Ivarsson A. Delay to celiac disease diagnosis and its implications for health-related quality of life. BMC Gastroenterol 2011; 11: 118.
Nordyke K, Norstrom F, Lindholm L, Stenlund H, Rosen A, Ivarsson A, Health-related quality of life in adolescents with screening-detected celiac disease, before and one year after diagnosis and initiation of gluten-free diet, a prospective nested case-referent study. BMC Public Health 2013; 13: 142.
De Lorenzo CM, Xikota JC, Wayhs MC, Nassar SM, de Souza Pires MM. Evaluation of the quality of life of children with celiac disease and their parents: a case–control study. Quality of Life Research 2012; 21: 77-85.
Feldman JM, Ortega AN, Koinis-Mitchell D, Kuo AA, Canino G. Child and family psychiatric and psychological factors associated with child physical health problems: results from the Boricua youth study. The Journal of Nervous and Mental Disease 2010; 198: 272.
Hornell A. Living well with celiac disease? J Pediatr Gastroenterol Nutr 2008; 47: 544-6.
Alonzo A. The experience of chronic illness and post-traumatic stress disorder: the consequences of cumulative adversity. Soc Sci Med 2000; 50: 1475-84.
Ludvigsson JF, Roy A, Lebwohl B, Green PH, Emilsson L. Anxiety and depression in caregivers of individuals with celiac disease-A population-based study. Digestive and Liver Disease 2017; 49: 273-79.
Oy B, Çocuklar için depresyon ölçeği: Geçerlilik ve güvenirlik çalışması. Turk Psikiyatri Derg 1991; 2:132-35.
Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press. 1970.
Öner N, Le Compte A. Durumluk-Sürekli Kaygı Envanteri El Kitabı. İstanbul. Boğaziçi Üniversitesi Yayınları. 1985.
Özusta H. Çocuklar için durumlu-sürekli kaygı envanteri uyarlama, geçerlik ve güvenirlik çalışması. Türk Psikoloji Dergisi 1995; 10: 32-44.
Varni JW, Seid M, Rode CA. The PedsQL: measurement model for the pediatric quality of life inventory. Medical care 1999; 37: 126-39.
Memik NC, Ağaoğlu B, Coşkun A, Karakay I. Çocuklar İçin yaşam kalitesi ölçeğinin 8-12 yaş çocuk formunun geçerlik ve güvenirliği. Çocuk ve Ergen Ruh Sağlığı Dergisi 2008; 15: 87-98.
Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical care 1992: 473-83.
Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş AK. Form-36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. Ilaç ve tedavi dergisi 1999; 12: 102-6.
Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM. The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. 9th annual convention of the international society for traumatic stress studies, San Antonio, TX. 1993.
Kocabaşoğlu N, Çorapçıoğlu Özdemir A, Yargıç İ, Geyran P. PTSD Checklist-Civilian Version Ölçeğinin geçerlilik ve güvenilirliği. Yeni Symposium 2005; 43: 126-34.
Arigo D, Anskis AM, Smyth JM. Psychiatric comorbidities in women with celiac disease. Chronic illness 2012; 8: 45-55.
Van Hees NJ, Van der Does W, Giltay EJ. Coeliac disease, diet adherence and depressive symptoms. Journal of psychosomatic research 2013; 74: 155-60.
Häuser W, Janke K-H, Klump B, Gregor M, Hinz A. Anxiety and depression in adult patients with celiac disease on a gluten-free diet. World journal of gastroenterology 2010; 16: 2780.
Esenyel S, Unal F, Vural P. Depression and anxiety in child and adolescents with follow-up celiac disease and in their families. The Turkish journal of gastroenterology: the official journal of Turkish Society of Gastroenterology 2014; 25: 381-5.
Addolorato G, Mirijello A, D'Angelo C, Leggio L, Ferrulli A, Vonghia L, et al. Social phobia in coeliac disease. Scandinavian journal of gastroenterology 2008; 43: 410-5.
Casellas F, Rodrigo L, Lucendo AJ, Molina-Infante J, Vivas S, Rosinach M, et al. Benefit on health-related quality of life of adherence to gluten-free diet in adult patients with celiac disease. Revista Española de Enfermedades Digestivas 2015; 107: 196-201.
Basso M, Crisogianni M, Di Ciommo V, Bracci F, Ferretti F, Baldini D, et al. Health-related quality of life in children and adolescents affected by coeliac disease. Digestive and Liver Disease 2007; 39: A55.
Biagetti C, Gesuita R, Gatti S, Catassi C. Quality of life in children with celiac disease: A paediatric cross-sectional study. Digestive and Liver Disease 2015; 47: 927-32.
Cabizuca M, Marques-Portella C, Mendlowicz MV, Coutinho ES, Figueira I. Posttraumatic stress disorder in parents of children with chronic illnesses: a meta-analysis. Health Psychology 2009; 28: 379.