title: Psychological Manifestations of Celiac Disease Autoimmunity in Young Children.
abstract: OBJECTIVE
  Psychological symptoms can be associated with celiac disease; however, this association has not been studied prospectively in a pediatric cohort. We examined mother report of psychological functioning in children persistently positive for tissue transglutaminase autoantibodies (tTGA), defined as celiac disease autoimmunity (CDA), compared with children without CDA in a screening population of genetically at-risk children. We also investigated differences in psychological symptoms based on mothers' awareness of their child's CDA status.
  
  
  METHODS
  The Environmental Determinants of Diabetes in the Young study followed 8676 children to identify triggers of type 1 diabetes and celiac disease. Children were tested for tTGA beginning at 2 years of age. The Achenbach Child Behavior Checklist assessed child psychological functioning at 3.5 and 4.5 years of age.
  
  
  RESULTS
  At 3.5 years, 66 mothers unaware their child had CDA reported more child anxiety and depression, aggressive behavior, and sleep problems than 3651 mothers of children without CDA (allPs ≤ .03). Unaware-CDA mothers also reported more child anxiety and depression, withdrawn behavior, aggressive behavior, and sleep problems than 440 mothers aware of their child's CDA status (allPs ≤.04). At 4.5 years, there were no differences.
  
  
  CONCLUSIONS
  In 3.5-year-old children, CDA is associated with increased reports of child depression and anxiety, aggressive behavior, and sleep problems when mothers are unaware of their child's CDA status. Mothers' knowledge of their child's CDA status is associated with fewer reports of psychological symptoms, suggesting that awareness of the child's tTGA test results affects reporting of symptoms.
authors.affiliation: Diabetes Center & Health Informatics Institute, Department of Pediatrics, and.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Smith
authors.affiliation: Health Informatics Institute, Morsani College of Medicine, University of South Florida, Tampa, Florida.
authors.forename: Kristian F
authors.initials: KF
authors.lastname: Lynch
authors.affiliation: Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland.
authors.forename: Kalle
authors.initials: K
authors.lastname: Kurppa
authors.affiliation: Dr von Hauner Children's Hospital, Ludwig Maximilian University, Munich, Germany.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
authors.affiliation: Diabetes Center & Health Informatics Institute, Department of Pediatrics, and.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Krischer
authors.affiliation: Digestive Health Institute, University of Colorado, Children's Hospital Colorado, Denver, Colorado.
authors.forename: Edwin
authors.initials: E
authors.lastname: Liu
authors.affiliation: Department of Medical Humanities and Social Sciences, Florida State University College of Medicine, Tallahassee, Florida; and.
authors.forename: Suzanne Bennett
authors.initials: SB
authors.lastname: Johnson
authors.affiliation: Unit of Diabetes and Celiac Disease, Malmö University, Malmö, Sweden daniel.agardh@med.lu.se.
authors.forename: Daniel
authors.initials: D
authors.lastname: Agardh
mesh_terms: D000374:Aggression / Q000523:psychology; D001007:Anxiety / Q000209:etiology; D001323:Autoantibodies / Q000097:blood; D002446:Celiac Disease / Q000276:immunology / Q000523:psychology*; D002675:Child, Preschool; D003863:Depression / Q000209:etiology; D005060:Europe; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers; D011446:Prospective Studies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012893:Sleep Wake Disorders / Q000209:etiology; D011503:Transglutaminases / Q000276:immunology; D014481:United States
chemical_list: D001323:Autoantibodies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins