Butwicka Agnieszka, Lichtenstein Paul, Frisén Louise, Almqvist Catarina, Larsson Henrik, Ludvigsson Jonas F
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland.
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
J Pediatr. 2017 May;184:87-93.e1. doi: 10.1016/j.jpeds.2017.01.043. Epub 2017 Mar 7.
To determine the risk of future childhood psychiatric disorders in celiac disease, assess the association between previous psychiatric disorders and celiac disease in children, and investigate the risk of childhood psychiatric disorders in siblings of celiac disease probands.
This was a nationwide registry-based matched cohort study in Sweden with 10 903 children (aged <18 years) with celiac disease and 12 710 of their siblings. We assessed the risk of childhood psychiatric disorders (any psychiatric disorder, psychotic disorder, mood disorder, anxiety disorder, eating disorder, psychoactive substance misuse, behavioral disorder, attention-deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and intellectual disability). HRs of future psychiatric disorders in children with celiac disease and their siblings was estimated by Cox regression. The association between previous diagnosis of a psychiatric disorder and current celiac disease was assessed using logistic regression.
Compared with the general population, children with celiac disease had a 1.4-fold greater risk of future psychiatric disorders. Childhood celiac disease was identified as a risk factor for mood disorders, anxiety disorders, eating disorders, behavioral disorders, ADHD, ASD, and intellectual disability. In addition, a previous diagnosis of a mood, eating, or behavioral disorder was more common before the diagnosis of celiac disease. In contrast, siblings of celiac disease probands were at no increased risk of any of the investigated psychiatric disorders.
Children with celiac disease are at increased risk for most psychiatric disorders, apparently owing to the biological and/or psychological effects of celiac disease.
确定乳糜泻患儿未来患儿童期精神障碍的风险，评估既往精神障碍与儿童乳糜泻之间的关联，并调查乳糜泻先证者的兄弟姐妹患儿童期精神障碍的风险。
这是一项在瑞典进行的基于全国登记系统的匹配队列研究，研究对象为10903名患有乳糜泻的儿童（年龄<18岁）及其12710名兄弟姐妹。我们评估了儿童期精神障碍（任何精神障碍、精神分裂症、心境障碍、焦虑症、进食障碍、精神活性物质滥用、行为障碍、注意力缺陷多动障碍[ADHD]、自闭症谱系障碍[ASD]和智力残疾）的风险。通过Cox回归估计乳糜泻患儿及其兄弟姐妹未来患精神障碍的风险比（HRs）。使用逻辑回归评估既往精神障碍诊断与当前乳糜泻之间的关联。
与普通人群相比，乳糜泻患儿未来患精神障碍的风险高1.4倍。儿童乳糜泻被确定为心境障碍、焦虑症、进食障碍、行为障碍、ADHD、ASD和智力残疾的风险因素。此外，在乳糜泻诊断之前，既往诊断为心境、进食或行为障碍更为常见。相比之下，乳糜泻先证者的兄弟姐妹患任何所调查精神障碍的风险均未增加。
乳糜泻患儿患大多数精神障碍的风险增加，显然是由于乳糜泻的生物学和/或心理影响。
