Mental Health Disorders and Psychosocial Distress in Pediatric Celiac Disease
Mental Health Disorders and Psychosocial Distress in Pediatric Celiac Disease
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DOI：
10.1097/mpg.0000000000002605
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发表时间：
2020-05-01
影响因子：
2.9
通讯作者：
Kahn, Ilana
中科院分区：
文献类型：
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作者：
Coburn, Shayna;Rose, Meredith;Kahn, Ilana
目的：乳糜泻（CeD）与儿童心理健康障碍（MHD）和心理社会困扰增加有关，这可能使无麸质饮食（GFD）治疗复杂化。这项单中心横断面研究检查了患有CeD的儿童的心理共病，以评估CeD护理的心理需求。方法：参与者是73名参加多学科乳糜泻诊所的儿童（3-18岁）的父母（95%为母亲）。父母完成了关于他们孩子的MHD历史，心理症状和GFD经历的电子调查。计算MHD的发生率，并与国家精神卫生研究所的人口水平数据进行比较。根据儿童年龄、CeD诊断后的时间和MHD检查了心理社会症状和GFD经历的差异。结果如下：34%的儿童患有至少1种MHD;焦虑障碍（16%，P < 0.001）和注意缺陷多动障碍（ADHD; 16%，P = 0.01）比一般人群更常见。超过四分之一的父母报告了目前的儿童心理社会困扰（28%-39%），大约一半的父母报告了与GFD相关的父母压力（51%）和经济负担（46%）。新诊断为CeD的儿童的父母对GFD的信心较低（P < 0.01），但MHD，压力和经济负担并没有随着CeD诊断的时间而变化。MHD患儿的焦虑、愤怒、总体抑郁和父母抑郁均高于非MHD患儿（P <0.05）。结论：CeD和MHD共病很常见，并且与儿童和父母心理社会困扰的增加有关。我们的研究结果强调了心理筛查和服务的重要性，以评估和治疗共病MHD，并减轻与GFD相关的心理社会困扰。
Objectives: Celiac disease (CeD) has been associated with increased mental health disorders (MHD) and psychosocial distress in children, which may complicate treatment with the gluten-free diet (GFD). This single-center cross-sectional study examined psychological comorbidities in children with CeD to assess psychological needs in CeD care. Methods: Participants were 73 parents (95% mothers) of children (ages 3-18) attending a multidisciplinary celiac disease clinic. Parents completed electronic surveys about their child's MHD history, psychological symptoms, and GFD experiences. Rates of MHD were calculated and compared with National Institute of Mental Health population-level data. Differences in psychosocial symptoms and GFD experiences were examined based on child age, time since CeD diagnosis, and MHD. Results: Thirty-four percentage of children had at least 1 MHD; anxiety disorders (16%,P < 0.001) and attention-deficit/hyperactivity disorder (ADHD; 16%,P = 0.01) were more common than general population rates. More than 1 quarter of parents reported current child psychosocial distress (28%-39%), and approximately half reported parent stress (51%) and financial burden (46%) associated with the GFD. Parents of children with new CeD diagnoses reported lower confidence in the GFD (P < 0.01) but MHD, stress, and financial burden did not differ by time since CeD diagnosis. Children with MHD had more anxiety, anger, overall distress, and parent distress than those without MHD (Ps < .05). Conclusions: Comorbid CeD and MHD was common and was associated with increased child and parent psychosocial distress. Our findings emphasize the importance of psychological screening and services to assess for and treat comorbid MHD and to mitigate psychosocial distress associated with the GFD.