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History of Coeliac Disease Associated with Risk for Schizophrenia
British Medical Journal (BMJ)
02/20/2004
By Joene Hendry
A history of coeliac disease is associated with an increased risk of developing schizophrenia, according to the findings of an epidemiological study conducted with data from national patients' registers in Denmark.
"The risk relation is strong but reflects a small proportion of cases of either disorder, since both disorders are rare," reports William W. Eaton, professor at Johns Hopkins University, Baltimore, Maryland, United States, and colleagues. They determined the relative risk of schizophrenia for individuals with autoimmune intestinal diseases including coeliac disease.
The case sample consisted of 7,997 patients over the age of 15, admitted to a Danish psychiatric facility between 1981 and 1998 with a first time diagnosis of schizophrenia and known maternal identity. Controls consisted of 199,915 randomly selected individuals matched to cases by year of birth and sex.
"The univariate relative risk for schizophrenia, given coeliac disease, was 3.2," the investigators report. This compares with a relative risk for schizophrenia of 1.3 among individuals with either Crohn's disease or ulcerative colitis.
After adjusting for covariates including wealth quarter of parents, urban residence, and family history of schizophrenia, the relative risk of schizophrenia in those with coeliac disease remained at 3.2, while the relative risk was 1.4 for those with either Crohn's disease or ulcerative colitis.
"Some clinical trials and case studies showed that a cereal free diet improved remission of symptoms of schizophrenia," the authors note, and "Removal of gluten from the diet is not dangerous or expensive and is an effective treatment for coeliac disease."
"An important question," they suggest, "is the degree to which removal of gluten from the diet will alleviate symptoms in the small proportion of people with schizophrenia who screen positively for coeliac disease but do not show its classical symptoms."
BMJ 2004;328:438-9.
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