Dohan FC (1966) Acta Psychiat Scand 42(2): 125-152
It is believed that sufficient evidence exists to suspect that some cereals, and possibly other foods, may play a role in the production of symptoms in those with the genotype for schizophrenia. This hypothesis is based on the following facts:
1. There is a good inter-country correlation between the per cent change from the prewar mean in the number of admissions of women with schizophrenia during World War IIand the per cent change from the prewar mean in the published values for wheat “consumption” (r = 0.908, 7 d. f., P < 0.01.)
2. The changes in the annual “consumption” of wheat within each of these countries exhibited a fairly good temporal and proportional relationship to changes in the annual number of women admitted with schizophrenia in each of these countries during World War II.
3. In general, the published estimates of prevalence, and of the “morbid risk,” of developing schizophrenia are highest-in populations which eat large amounts of wheat (Europe) ; in the middle range-in populations eating relatively little wheat and large amounts of rice (Japan, Taiwan Chinese); quite low in a population whose staple foods are primarily sweet potatoes, millet, corn and some rice (Taiwan aborigines); and may possibly be even lower in two populations of non-westernized Africans whose staple foodstuffs were maize or millets and sorghums.
4. Celiac disease, a disorder made symptomatic by the ingestion of wheat and certain other cereals, has been reported to be associated with a high frequency of schizophrenia and emotional disorders and to have been experienced in childhood by an unusually high proportion of those with schizophrenia.
The hypothesis is one that may be tested. It is suggested that those with an initial attack of schizophrenia or an acute relapse from a relatively normal state be the subjects of such trials. Absolutely complete and continuous omission of all of those substances which have been reported to produce symptoms in patients with celiac disease would seem advisable as would the refeeding of such substances if substantial improvement in unbiased psychiatric ratings of the patients occurs. The vagaries in time and intensity of the response of the patient with celiac disease to a “gluten-free” diet and refeeding of wheat and the reported effect of “traces” may serve as a model in planning and interpreting similar observations in patients with schizophrenia.