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A wide range of psychological problems can arise for those with untreated celiac disease or non-celiac gluten sensitivity. Initially there may be a misdiagnosis of psychiatric illness due to some of the neurological and psychiatric symptoms that can be seen in untreated disease. Once diagnosed, there may be difficulty adjusting to a new diagnosis of chronic illness and adherence to a gluten-free diet. In patients with celiac disease, a 10-22% increased risk of neurological disorders is reported.


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When a Mental Health Referral is Needed

A wide range of psychological problems can arise for patients with untreated celiac disease or non-celiac gluten sensitivity. These can include difficulties adjusting to a new diagnosis of chronic illness as well as dealing with adherence to a gluten-free diet and other aspects of disease management. Protracted duration of emotional or behavioral symptoms, greater severity of symptoms, and/or significant impairment in functioning are indicators of potential need for mental health treatment. These include:

  • Finding little or no pleasure in life
  • Feeling worthless or extremely guilty
  • Crying a lot for no particular reason
  • Withdrawing from other people
  • Experiencing severe anxiety, panic or fear
  • Having big mood swings
  • Experiencing a change in eating or sleeping patterns
  • Having very low energy
  • Losing interest in hobbies or pleasurable activities
  • Having too much energy, having trouble concentrating or following through on plans
  • Feeling easily irritated or angry
  • Experiencing racing thoughts or agitation
  • Hearing voices or seeing images that other people do not experience
  • Believing that others are plotting against you
  • Wanting to harm yourself or someone else

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Case Examples

The following are three case examples of children and adolescents with diagnosed celiac disease who would benefit from mental health evaluation and treatment.


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When a Medical Evaluation is Needed

Initially those with celiac disease or non-celiac gluten sensitivity may be misdiagnosed with a psychiatric illness due to some of the neurological and psychiatric symptoms that can be seen in untreated disease including:

  • Mood changes
  • Anxiety
  • Fatigue
  • Difficulties with concentration and attention
  • Sleep difficulties
  • Decreased appetite

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Case Examples

The following are three case examples patients seen for mental health treatment, for whom a referral for evaluation of celiac disease or non-celiac wheat sensitivity is recommended.


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