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The Indian Journal of Pediatrics

, Volume 86, Issue 5, pp 427–432 | Cite as

Assessment of Quality of Life, Anxiety and Depressive Symptoms in Serbian Children with Celiac Disease and their Parents

  • Biljana Stojanović
  • Aleksandar KočovićEmail author
  • Nedeljko Radlović
  • Zoran Leković
  • Dragan Prokić
  • Nela Đonović
  • Stevan Jovanović
  • Biljana Vuletić
Original Article

Abstract

Objectives

To evaluate the level of health-related quality of life (QoL) and presence of anxiety and depressive symptoms in Serbian children with celiac disease from the perspective of patients and their parents.

Methods

This cross-sectional study investigated the group of children and adolescents with celiac disease aged 5–18 y, and at least one parent of each patient with celiac disease. The patients and their parents were recruited at the Institute of Mother and Child Health of Serbia and the University Children’s Hospital in Belgrade. The instruments used in this study were child-self and parent-proxy versions of the Pediatric Quality of Life Inventory (PedsQL), Screen for Child Anxiety Related Emotional Disorder (SCARED) and Short Mood and Feelings Questionnaire (MFQ). Additional information was collected from the medical records of each patient.

Results

According to the PedsQL questionnaire, the quality of life was similarly assessed by both parents and their children (p > 0.05), as well as the presence of depressive symptoms according to MFQ questionnaire. However, a statistically significant difference was observed in the total score of the SCARED questionnaire for children and parents [total score (p < 0.05), panic-somatic disturbance (p < 0.01) and social anxiety (p < 0.01)].

Conclusions

The patients and their parents in Serbia have similarly assessed the quality of life of children with celiac disease, but the differences in the scores of SCARED questionnaire indicate that it is necessary to include both children and parents in the assessment of QOL.

Keywords

Celiac disease Children Quality of life Anxiety Depression 

Notes

Author Contributions

All authors have contributed equally to the research, statistical processing of results and the writing of this article. Biljana Vuletic will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

Source of Funding

None.

References

  1. 1.
    Schaart MW, Mearin ML. Early nutrition: prevention of celiac disease? J Pediatr Gastroenterol Nutr. 2014;59:S18–20.CrossRefPubMedGoogle Scholar
  2. 2.
    Husby S, Koletzko S, Korponay-Szabó IR, et al; ESPGHAN Working Group on Coeliac Disease Diagnosis; ESPGHAN Gastroenterology Committee; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr. 2012;54:136–60.Google Scholar
  3. 3.
    Radlović N. Celiac disease. Srp Arh Celok Lek. 2013;141:122–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Valitutti F, Trovato CM, Montuori M, Cucchiara S. Pediatric celiac disease: follow-up in the spotlight. Adv Nutr. 2017;8:356–61.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Epstein I, Stinson J, Stevens B. The effects of camp on health-related quality of life in children with chronic illnesses: a review of the literature. J Pediatr Oncol Nurs. 2005;22:89–103.Google Scholar
  6. 6.
    Testa MA, Simonson DC. Assesment of quality-of-life outcomes. N Engl J Med. 1996;334:835–40.CrossRefPubMedGoogle Scholar
  7. 7.
    Häuser W, Gold J, Stallmach A, Caspary WF, Stein J. Development and validation of the celiac disease questionnaire (CDQ), a disease-specific health-related quality of life measure for adult patients with celiac disease. J Clin Gastroenterol. 2007;41:157–66.CrossRefPubMedGoogle Scholar
  8. 8.
    Van Doorn RK, Winkler LM, Zwinderman KH, Mearin ML, Koopman HM. CDDUX: a disease-specific health-related quality-of-life questionnaire for children with celiac disease. J Pediatr Gastroenterol Nutr. 2008;47:147–52.CrossRefPubMedGoogle Scholar
  9. 9.
    Aksan A, Mercanlıgil SM, Häuser W, Karaismailoğlu E. Validation of the Turkish version of the celiac disease questionnaire (CDQ). Health Qual Life Outcomes. 2015;13:82.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Marchese A, Klersy C, Biagi F, et al. Quality of life in coeliac patients: Italian validation of a coeliac questionnaire. Eur J Intern Med. 2013;24:87–91.Google Scholar
  11. 11.
    Pouchot J, Despujol C, Malamut G, Ecosse E, Coste J, Cellier C. Validation of a French version of the quality of life "celiac disease questionnaire". PLoS One. 2014;9:e96346.Google Scholar
  12. 12.
    Lins MT, Tassitano RM, Brandt KG, Antunes MM, Silva GA. Translation, cultural adaptation, and validation of the celiac disease DUX (CDDUX). J Pediatr. 2015;91:448–54.CrossRefGoogle Scholar
  13. 13.
    Biagetti C, Gesuita R, Gatti S, Catassi C. Quality of life in children with celiac disease: a paediatric cross-sectional study. Dig Liver Dis. 2015;47:927–32.CrossRefPubMedGoogle Scholar
  14. 14.
    Smith DF, Gerdes LU. Meta-analysis on anxiety and depression in adult celiac disease. Acta Psychiatr Scand. 2012;125:189–9.Google Scholar
  15. 15.
    Esenyel S, Unal F, Vural P. Depression and anxiety in child and adolescents with follow-up celiac disease and in their families. Turk J Gastroenterol. 2014;25:381–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Stevanović D, Lakić A, Damnjanović M. Some psychometric properties of the pediatric quality of life inventory™ version 4.0 generic Core scales (PedsQL™) in the general Serbian population. Qual Life Res. 2011;20:945–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Stevanović D. Childhood depression and anxiety disorders in Serbia: a psychometric study of four screening questionnaires. Epidemiol Psychiatr Sci. 2012;21:111–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates; 1988.Google Scholar
  19. 19.
    Kuburovic NB, Pasic S, Susic G, et al. Health-related quality of life, anxiety, and depressive symptoms in children with primary immunodeficiencies. Patient Prefer Adherence. 2014;8:323–30.Google Scholar
  20. 20.
    Byström IM, Hollén E, Fälth-Magnusson K, Johansson A. Health-related quality of life in children and adolescents with celiac disease: from the perspectives of children and parents. Gastroenterol Res Pract. 2012;2012:986475.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Barrio J, Román E, Cilleruelo M, Márquez M, Mearin M, Fernández C. Health-related quality of life in spanish children with coeliac disease. J Pediatr Gastroenterol Nutr. 2016;62:603–8.Google Scholar
  22. 22.
    Pico M, Spirito MF, Roizen M. Quality of life in children and adolescents with celiac disease: Argentinian version of the specific questionnaire CDDUX. Acta Gastroenterol Latinoam. 2012;42:12–9.PubMedGoogle Scholar
  23. 23.
    Varni JW, Limbers CA, Burwinkle TM. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL 4.0 generic Core scales. Health Qual Life Outcomes. 2007;5:43.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Mazzone L, Reale L, Spina M, et al. Compliant gluten-free children with celiac disease: an evaluation of psychological distress. BMC Pediatr. 2011;11:46.Google Scholar
  25. 25.
    Häuser W, Janke KH, Klump B, Gregor M, Hinz A. Anxiety and depression in adult patients with celiac disease on a gluten-free diet. World J Gastroenterol. 2010;16:2780–7.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Ciacci C, Iavarone A, Siniscalchi M, Romano R, De Rosa A. Psychological dimensions of celiac disease: toward an integrated approach. Dig Dis Sci. 2002;47:2082–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Addolorato G. Anxiety but not depression decrease in celiac patients after one year gluten free diet: a longitudinal study. Scan J Gastroenterol. 2001;36:502–6.CrossRefGoogle Scholar
  28. 28.
    Kolsteren MM, Koopman HM, Schalekamp G, Mearin ML. Health-related quality of life in children with celiac disease. J Pediatr. 2001;138:593–5.CrossRefPubMedGoogle Scholar
  29. 29.
    Jellinek MS, Murphy JM, Little M, Pagano ME, Comer DM, Kelleher KJ. Use of the pediatric symptom checklist to screen for psychosocial problems in pediatric primary care. Arch Pediatr Adole Med. 1999;153:254–60.CrossRefGoogle Scholar
  30. 30.
    Zarkadas M, Dubois S, MacIsaac K. Living with coeliac disease and a gluten-free diet: a Canadian perspective. J Hum Nutr Diet. 2013;26:10–23.Google Scholar
  31. 31.
    Chauhan JC, Kumar P, Dutta AK, Basu S, Kumar A. Assessment of dietary compliance to gluten free diet and psychosocial problems in Indian children with celiac disease. Indian J Pediatr. 2010;77:649–54.CrossRefPubMedGoogle Scholar
  32. 32.
    Stone K, Storey J, Hughes F. Perceived stress and comorbid illness predict depressive symptomatology in people with coeliac disease. Austral Psychol. 2012;47:198–203.CrossRefGoogle Scholar
  33. 33.
    Black JL, Orfila C. Impact of coeliac disease on dietary habits and quality of life. J Hum Nutr Diet. 2011;24:582–7.CrossRefPubMedGoogle Scholar
  34. 34.
    Addolorato G, Di Giuda D, De Rossi G, et al. Regional cerebral hypoperfusion in patients with celiac disease. Am J Med. 2004;116:312–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Solaymani-Dodaran M, West J, Logan RF. Long-term mortality in people with celiac disease diagnosed in childhood compared with adulthood: a population-based cohort study. Am J Gastroenterol. 2007;102:864–70.CrossRefPubMedGoogle Scholar
  36. 36.
    White LE, Bannerman E, Gillett PM. Coeliac disease and the gluten-free diet: a review of the burdens; factors associated with adherence and impact on health-related quality of life, with specific focus on adolescence. J Hum Nutr Diet. 2016;29:593–606.CrossRefPubMedGoogle Scholar
  37. 37.
    Di Filippo T, Orlando MF, Concialdi G, et al. The quality of life in developing age children with celiac disease. Minerva Pediatr. 2013;65:599–608.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  • Biljana Stojanović
    • 1
  • Aleksandar Kočović
    • 2
    Email author
  • Nedeljko Radlović
    • 3
  • Zoran Leković
    • 4
    • 5
  • Dragan Prokić
    • 6
  • Nela Đonović
    • 7
  • Stevan Jovanović
    • 1
  • Biljana Vuletić
    • 8
  1. 1.Higher Education School of Professional Health StudiesBelgradeSerbia
  2. 2.Faculty of Medical Sciences, Department of PharmacyUniversity of KragujevacKragujevacSerbia
  3. 3.Academy of Medical Sciences of the Serbian Medical SocietyBelgradeSerbia
  4. 4.Faculty of Medical SciencesUniversity of BelgradeBelgradeSerbia
  5. 5.University Children HospitalBelgradeSerbia
  6. 6.Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic” BelgradeBelgradeSerbia
  7. 7.Faculty of Medical Sciences, Department of Hygiene and EcologyUniversity of KragujevacKragujevacSerbia
  8. 8.Faculty of Medical Sciences, Department of PediatricsUniversity of KragujevacKragujevacSerbia

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