Jackson JR, Eaton WW, Cascella NG, Fasano A, Kelly DL (2012) Psychiatr Q. 2012 Mar;83(1):91-102
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Celiac Disease (CD) is an immune-mediated disease dependent on gluten (a protein present in wheat, rye or barley) that occurs in about 1% of the population and is generally characterized by gastrointestinal complaints.
More recently the understanding and knowledge of gluten sensitivity (GS), has emerged as an illness distinct from celiac disease with an estimated prevalence 6 times that of CD. Gluten sensitive people do not have villous atrophy or antibodies that are present in celiac disease, but rather they can test positive for antibodies to gliadin.
Both CD and GS may present with a variety of neurologic and psychiatric co-morbidities, however, extraintestinal symptoms may be the prime presentation in those with GS. However, gluten sensitivity remains undertreated and underrecognized as a contributing factor to psychiatric and neurologic manifestations.
This review focuses on neurologic and psychiatric manifestations implicated with gluten sensitivity, reviews the emergence of gluten sensitivity distinct from celiac disease, and summarizes the potential mechanisms related to this immune reaction.
This review explains why many people who do not have Coeliac disease (the classic form of gluten intolerance) may nonetheless benefit from a gluten-free diet.
The medical establishment has now acknowledged that other forms of sensitivity to gluten do exist - and although their mechanisms are not fully understood, neurological or psychological symptoms appear to be more common in non-coeliac gluten-sensitivity (NCGS) than in coeliac disease itself.
Neurological and psychiatric symptoms resulting from NCGS are highly variable, but may include symptoms otherwise characteristic of anxiety, depression, dyspraxia, autism or schizophrenia
See also: Pietzak (2012) Coeliac disease, wheat allergy and gluten sensitivity - When gluten-free is not a fad
Sapone et al (2012) Spectrum of gluten-related disorders: consensus on new nomenclature and classification