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Attention deficit and hyperactivity disorder symptoms respond to gluten-free diet in patients with coeliac disease
Authors:Vendel A. Kristensen  Jørgen Valeur  Stephan Brackmann  Jørgen Jahnsen  Cathrine Brunborg  Kari Tveito
Affiliation:1. Department of Gastroenterology, Oslo University Hospital, Oslo, Norway;2. Lovisenberg Diaconal Hospital, Unger-Vetlesen Institute, Oslo, Norway;3. Department of Gastroenterology, Akershus University Hospital, L?renskog, Norway;4. Institute of Clinical Medicine, University of Oslo, Oslo, Norway;5. Oslo Centre for Biostatistics and Epidemiology, Research Support Services Oslo University Hospital, Oslo, Norway;6. Lovisenberg Diaconal Hospital, Unger-Vetlesen Institute, Oslo, Norway;7. The Norwegian Medical Association, Oslo, Norway
Abstract:Introduction: Patients with coeliac disease commonly report symptoms of ‘brain fog’. The aim of this study was to assess self-reported symptoms of impaired concentration in coeliac disease before and after treatment with gluten-free diet, compared with healthy controls and patient controls.

Methods: Patients with newly diagnosed coeliac disease were included consecutively from two out-patient clinics. The patients completed the questionnaires Adult ADHD Self-Report Scale v1.1 Symptoms Checklist (ASRS), Hospital Anxiety and Depression Scale (HADS) and Gastrointestinal Symptom Rating Scale (GSRS) prior to start of a gluten-free diet and after at least 12 months on the diet. Patients with an established diagnosis of inflammatory bowel disease served as patient controls (n?=?36). Health care personnel at Oslo University Hospital served as healthy controls (n?=?60) and filled out ASRS and HADS.

Results: A total of 31 newly diagnosed coeliac patients were included in the study. Of these, 26 patients met for follow-up and repeated the questionnaires. Prior to treatment, patients with coeliac disease had significantly higher scores than healthy controls on both the ASRS (p?=?.0014) and HADS (p=.0004). After a gluten-free diet, their scores improved and were not significantly different from healthy controls. There were no significant differences between patients with coeliac disease prior to treatment and patient controls with inflammatory bowel disease.

Conclusion: Prior to treatment, coeliac disease patients reported significantly more symptoms than healthy controls on ASRS and HADS. The differences disappeared after a minimum of 12 months on a gluten-free diet.

Keywords:Coeliac disease  cognitive impairment  gluten-free diet  anxiety  depression  inattention  psychological symptoms  brain fog
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