Bozas Antonios, Karakatsoulis Georgios, Panagopoulou Efharis, Xinias Ioannis, Fotoulaki Maria
4th Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Institute of Applied Biosciences, Center for Research and Technology Hellas (CERTH), Thessaloniki, GRC.
Cureus. 2024 Nov 20;16(11):e74103. doi: 10.7759/cureus.74103. eCollection 2024 Nov.
Introduction Adolescence is a pivotal time for individuals with celiac disease (CD), presenting a host of psychosocial challenges. Managing a strict gluten-free diet (GFD) while forming self-identity, striving for autonomy, and navigating social relationships significantly impacts adolescents with CD. The present pilot study investigates the impact of psychological factors on behavioral and dietary responses in adolescents with CD, utilizing repeated measures over time. Methods Thirty-one adolescents aged 11-18 from a pediatric outpatient CD department were recruited. Participants completed the Resilience Youth Development Module (RYDM), the Child and Adolescent Mindfulness Measure (CAMM), the Strengths and Difficulties Questionnaire (SDQ), and Celiac Dietary Adherence Test (CDAT) over four phases spanning four months. Twenty-seven parents also agreed to participate in completing the SDQ parents' version. Results The results revealed moderate levels of mindfulness and resilience, accompanied by inadequate adherence to a GFD. Baseline assessments revealed difficulties in peer relationships and psychosocial functioning, which parents corroborated. Over time, reductions in mindfulness and resilience were observed, along with modest improvements in dietary adherence and decreases in psychosocial difficulties. Discussion This study underscores the importance of psychological traits, suggesting that enhancing mindfulness and resilience may improve both dietary adherence and overall well-being. However, given the dynamic nature of adolescents' coping strategies through developmental changes and social environments, tailored interventions are essential for effective disease management and social integration.
引言
青春期对于患有乳糜泻（CD）的个体来说是一个关键时期，会带来一系列心理社会挑战。在形成自我认同、追求自主性以及处理社会关系的同时，坚持严格的无麸质饮食（GFD）对患有CD的青少年有重大影响。本试点研究通过长期重复测量，调查心理因素对患有CD的青少年行为和饮食反应的影响。
方法
招募了31名来自儿科门诊CD科室的11 - 18岁青少年。参与者在四个月的四个阶段中完成了青少年复原力发展模块（RYDM）、儿童和青少年正念测量（CAMM）、优势与困难问卷（SDQ）以及乳糜泻饮食依从性测试（CDAT）。27名家长也同意参与完成SDQ家长版。
结果
结果显示正念和复原力处于中等水平，同时对GFD的依从性不足。基线评估揭示了同伴关系和心理社会功能方面的困难，家长也证实了这一点。随着时间推移，观察到正念和复原力有所下降，饮食依从性有适度改善，心理社会困难有所减少。
讨论
本研究强调了心理特质的重要性，表明增强正念和复原力可能改善饮食依从性和整体幸福感。然而，鉴于青少年通过发展变化和社会环境所采用的应对策略具有动态性，量身定制的干预措施对于有效的疾病管理和社会融合至关重要。
