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Association of Attention-Deficit/Hyperactivity Disorder and Celiac Disease: A Brief Report

Prim Care Companion CNS Disord 2011;13(3):e1-e3
10.4088/PCC.10br01104

Objective: A possible association of celiac disease with psychiatric and psychological disturbances such as attention-deficit/hyperactivity disorder (ADHD) has been reported repeatedly. The objective of this study was to observe whether a gluten-free diet could alleviate the behavioral symptoms in patients with celiac disease and ADHD.

Method: Sixty-seven subjects aged 7 to 42 years (mean = 11.4 years) with ADHD were enrolled in the study in South Tyrol, Italy, from 2004 to 2008. Hypescheme, an operational criteria checklist that incorporates DSM-IV and ICD-10 criteria, was used to assess ADHD-like symptomatology. Additionally, blood serum levels of all subjects were assessed for possible celiac disease by examining antigliadine and antiendomysium antibodies. A gluten-free diet was initiated for at least 6 months in celiac disease–positive patients with ADHD.

Results: Of the 67 patients with ADHD, 10 were positive for celiac disease. After initiation of the gluten-free diet, patients or their parents reported a significant improvement in their behavior and functioning compared to the period before celiac diagnosis and treatment, which was evident in the overall mean score on the Hypescheme questionnaire (t = 4.22, P = .023).

Conclusions: Celiac disease is markedly overrepresented among patients presenting with ADHD. A gluten-free diet significantly improved ADHD symptoms in patients with celiac disease in this study. The results further suggest that celiac disease should be included in the ADHD symptom checklist.

Prim Care Companion CNS Disord 2011;13(3):e1–e3

Submitted: October 28, 2010; accepted November 2, 2010.

Published online: June 16, 2011 (doi:10.4088/PCC.10br01104).

Corresponding author: Helmut Niederhofer, MD, PhD, Psychiatric Hospital of Rodewisch, Child Psychiatry, Bahnhofstrasse, Rodewisch, SN 08228, Germany (helmutniederhofer@yahoo.de).