TRANSTORNOS ALIMENTARES EM PACIENTES COM DOENÇA CELÍACA
UMA REVISÃO DE ESCOPO RÁPIDA
DOI:
https://doi.org/10.63845/07f1nf14Keywords:
Doença Celíaca, Transtornos da Alimentação e da Ingestão de Alimentos, Estresse PsicológicoAbstract
A gestão da doença celíaca envolve a adesão rigorosa a uma dieta isenta de glúten, o que, em alguns casos, pode estar associado a uma série de comportamentos alimentares e psicológicos, potencialmente relacionados a transtornos alimentares. Objetivo: Trata-se de uma revisão de escopo rápida que teve por objetivo mapear os fatores associados à adesão à dieta isenta de glúten em pacientes com doença celíaca e sua relação com o desenvolvimento de transtornos alimentares. Metodologia: A revisão seguiu as recomendações do protocolo PRISMA ScR e buscou estudos na PubMed, Scopus, Web of Science, PSYCInfo, CINAHL, LILACS e SciELO. Resultados: Foram incluídos 30 estudos sem recorte idiomático e temporal, com predominância de delineamentos transversais e coorte. Diversos fatores foram identificados como possíveis influências nesse processo, incluindo sintomas psicológicos, questões relacionadas à imagem corporal, presença de sintomas gastrointestinais e as exigências da dieta restritiva. Conclusões: A relação entre doença celíaca e transtornos alimentares é multifatorial e bidirecional. Esses achados reforçam a necessidade de triagem sistemática e de uma abordagem interdisciplinar envolvendo gastroenterologia, nutrição e psicologia, de modo a garantir o manejo integral da condição celíaca e a prevenção de transtornos alimentares associados.
References
Murray J, Scanlon SA. Update on celiac disease – etiology, differential diagnosis, drug targets, and management advances. Clin Exp Gastroenterol. 2011;297. DOI: 10.2147/CEG.S8315 DOI: https://doi.org/10.2147/CEG.S8315
Barker JM, Liu E. Celiac Disease: Pathophysiology, Clinical Manifestations, and Associated Autoimmune Conditions. Adv Pediatr. 2008;55(1):349–65. DOI: 10.1016/j.yapd.2008.07.001 DOI: https://doi.org/10.1016/j.yapd.2008.07.001
Gallegos C, Merkel R. Current Evidence in the Diagnosis and Treatment of Children With Celiac Disease. Gastroenterology Nursing. 2019;42(1):41–8. DOI: 10.1097/SGA.0000000000000365 DOI: https://doi.org/10.1097/SGA.0000000000000365
Leeds JS, Hopper AD, Sanders DS. Coeliac disease. Br Med Bull. 2008;88(1):157–70. DOI: 10.1093/bmb/ldn044 DOI: https://doi.org/10.1093/bmb/ldn044
Violato M, Gray A. The impact of diagnosis on health-related quality of life in people with coeliac disease: a UK population-based longitudinal perspective. BMC Gastroenterol. 2019;19(1):68. DOI: 10.1186/s12876-019-0980-6 DOI: https://doi.org/10.1186/s12876-019-0980-6
Ciccarelli SK, White JN. Psychology: Diagnostic and Statistical Manual of Mental Disorders. 5o ed. 2013.
Hilbert A, Hoek HW, Schmidt R. Evidence-based clinical guidelines for eating disorders. Curr Opin Psychiatry. 2017;30(6):423–37. DOI: 10.1097/YCO.0000000000000360 DOI: https://doi.org/10.1097/YCO.0000000000000360
World Health Organization. World health statistics 2022: monitoring health for the SDGs, sustainable development goals [Internet]. 2022 [citado 19 de julho de 2025]. Recuperado: https://cdn.who.int/media/docs/default-source/gho-documents/world-health-statistic-reports/worldhealthstatistics_2022.pdf
Lebwohl B, Haggård L, Emilsson L, Söderling J, Roelstraete B, Butwicka A, et al. Psychiatric Disorders in Patients With a Diagnosis of Celiac Disease During Childhood From 1973 to 2016. Clin Gastroenterol Hepatol. 2021;19(10):2093-2101.e13. DOI: 10.1016/j.cgh.2020.08.018 DOI: https://doi.org/10.1016/j.cgh.2020.08.018
Karwautz A, Wagner G, Berger G, Sinnreich U, Grylli V, Huber W-D. Eating pathology in adolescents with celiac disease. Psychosomatics: Journal of Consultation and Liaison Psychiatry. Karwautz, Andreas: Dept of Child and Adolescent Psychiatry, Medical Univ. of Vienna, Waehringer Guertel 18-20, Vienna, Austria, A-1090, [email protected]: American Psychiatric Assn; 2008;48(5):399–406. DOI: 10.1176/appi.psy.49.5.399 DOI: https://doi.org/10.1176/appi.psy.49.5.399
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73. DOI: 10.7326/M18-0850 DOI: https://doi.org/10.7326/M18-0850
Araújo WCO. Recuperação da informação em saúde. ConCI: Convergências em Ciência da Informação. 2020;3(2):100–34. DOI: 10.33467/conci.v3i2.13447 DOI: https://doi.org/10.33467/conci.v3i2.13447
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;n71. DOI: 10.1136/bmj.n71 DOI: https://doi.org/10.1136/bmj.n71
Haddaway NR, Page MJ, Pritchard CC, McGuinness LA. PRISMA2020 : An R package and Shiny app for producing PRISMA 2020‐compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews. 2022;18(2). DOI: 10.1002/cl2.1230 DOI: https://doi.org/10.1002/cl2.1230
Arigo D, Anskis AM, Smyth JM. Psychiatric comorbidities in women with Celiac Disease. Chronic Illn. Smyth, Joshua M.: Department of Biobehavioral Health, 315 Health and Human Development East, University Park, PA, US, 16802, [email protected]: Sage Publications; 2012;8(1):45–55. DOI: 10.1177/1742395311417639 DOI: https://doi.org/10.1177/1742395311417639
Urban-Kowalczyk M. Psychiatric complications of celiac disease. International Journal of Celiac Disease. Department of Affective and Psychotic Disorder, Medical University of Lodz, Poland: Science and Education Publishing; 2015;3(1):25–7. DOI: 10.12691/ijcd-3-1-1 DOI: https://doi.org/10.12691/ijcd-3-1-1
Satherley R-M, Howard R, Higgs S. The prevalence and predictors of disordered eating in women with coeliac disease. Appetite. Satherley, Rose-Marie: School of Psychology, University of Birmingham, Frankland Building, Edgbaston, Birmingham, United Kingdom, B15 2TT, [email protected]: Elsevier Science; 2016;107:260–7. DOI: 10.1016/j.appet.2016.07.038 DOI: https://doi.org/10.1016/j.appet.2016.07.038
Mascolo M, Geer B, Feuerstein J, Mehler PS. Gastrointestinal comorbidities which complicate the treatment of anorexia nervosa. Eat Disord. Department of Medicine, ACUTE, Denver Health, Denver, Colorado, USA: Routledge; 2017;25(2):122–33. DOI: 10.1080/10640266.2016.1255108 DOI: https://doi.org/10.1080/10640266.2016.1255108
Cossu G, Carta MG, Contu F, Mela Q, Demelia L, Elli L, et al. Coeliac disease and psychiatric comorbidity: epidemiology, pathophysiological mechanisms, quality-of-life, and gluten-free diet effects. International Review of Psychiatry. Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy: Taylor and Francis Ltd; 2017;29(5):489–503. DOI: 10.1080/09540261.2017.1314952 DOI: https://doi.org/10.1080/09540261.2017.1314952
Butwicka A, Lichtenstein P, Frisén L, Almqvist C, Larsson H, Ludvigsson JF. Celiac Disease Is Associated with Childhood Psychiatric Disorders: A Population-Based Study. Journal of Pediatrics. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden: Elsevier B.V.; 2017;184:87-93.e1. DOI: 10.1016/j.jpeds.2017.01.043 DOI: https://doi.org/10.1016/j.jpeds.2017.01.043
Mådrid K, Størdal K, Bulik CM, Rewers M, Ekbom A, Liu E, et al. Celiac Disease and Anorexia Nervosa: A Nationwide Study. Pediatrics. Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway: American Academy of Pediatrics; 2017;139(5):1–9. DOI: 10.1542/peds.2016-4367 DOI: https://doi.org/10.1542/peds.2016-4367
Nacinovich R, Tremolizzo L, Corbetta F, Conti E, Neri F, Bomba M. A norexia nervosa of the restrictive type and celiac disease in adolescence. Neuropsychiatr Dis Treat. Univ Milano Bicocca, Child & Adolescent Mental Hlth Dept, San Gerardo Hosp, Sch Med & Surg, Monza, Italy; 2017;13:1211–4. DOI: 10.2147/NDT.S124168 WE - Science Citation Index Expanded (SCI-EXPANDED) WE - Social Science Citation Index (SSCI) DOI: https://doi.org/10.2147/NDT.S124168
Slim M, Rico-Villademoros F, Calandre EP. Psychiatric Comorbidity in Children and Adults with Gluten-Related Disorders: A Narrative Review. Nutrients. Division of Neurology, The Hospital for Sick Children, The Peter Gilgan Centre for Research and Learning, 686 Bay St., Toronto, ON M5G 0A4, Canada: MDPI; 2018;10(7):875. DOI: 10.3390/nu10070875 DOI: https://doi.org/10.3390/nu10070875
Tokatly Latzer I, Rachmiel M, Zuckerman Levin N, Mazor‐Aronovitch K, Landau Z, Ben‐David RF, et al. Increased prevalence of disordered eating in the dual diagnosis of type 1 diabetes mellitus and celiac disease. Pediatr Diabetes. Department of Pediatrics A, The Edmond and Lily Safra Children’s Hospital, Chaim Sheba Medical Center, Ramat‐Gan, Israel: Hindawi Limited; 2018;19(4):749–55. DOI: 10.1111/pedi.12653 DOI: https://doi.org/10.1111/pedi.12653
Avila JT, Park KT, Golden NH. Eating disorders in adolescents with chronic gastrointestinal and endocrine diseases. Lancet Child Adolesc Health. 2019;3(3):181–9. DOI: 10.1016/S2352-4642(18)30386-9 DOI: https://doi.org/10.1016/S2352-4642(18)30386-9
Hedman A, Breithaupt L, Hübel C, Thornton LM, Tillander A, Norring C, et al. Bidirectional relationship between eating disorders and autoimmune diseases. Journal of Child Psychology. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm Sweden: Wiley-Blackwell; 2019;60(7):803–12. DOI: 10.1111/jcpp.12958 DOI: https://doi.org/10.1111/jcpp.12958
Tokatly Latzer I, Lerner-Geva L, Stein D, Weiss B, Pinhas-Hamiel O. Disordered eating behaviors in adolescents with celiac disease. Eating & Weight Disorders. Department of Pediatrics A, Tel Aviv University, Tel Aviv, Israel: Springer Nature; 2020;25(2):365–71. DOI: 10.1007/s40519-018-0605-z DOI: https://doi.org/10.1007/s40519-018-0605-z
Clappison E, Hadjivassiliou M, Zis P. Psychiatric Manifestations of Coeliac Disease, a Systematic Review and Meta-Analysis. Nutrients. Medical School, University of Sheffield, Sheffield S10 2YN, UK: MDPI; 2020;12(1):142. DOI: 10.3390/nu12010142 DOI: https://doi.org/10.3390/nu12010142
Gibson D, Watters A, Mehler PS. The intersect of gastrointestinal symptoms and malnutrition associated with anorexia nervosa and avoidant/restrictive food intake disorder: Functional or pathophysiologic?—A systematic review. International Journal of Eating Disorders. ACUTE at Denver Health, Denver Colorado, USA: Wiley-Blackwell; 2021;54(6):1019–54. DOI: 10.1002/eat.23553 DOI: https://doi.org/10.1002/eat.23553
Peters JE, Basnayake C, Hebbard GS, Salzberg MR, Kamm MA. Prevalence of disordered eating in adults with gastrointestinal disorders: A systematic review. Neurogastroenterology and motility. 2022;34(8):e14278–e14278. DOI: 10.1111/nmo.14278 DOI: https://doi.org/10.1111/nmo.14278
Alkhayyat M, Qapaja T, Aggarwal M, Almomani A, Abureesh M, Al-Otoom O, et al. Epidemiology and risk of psychiatric disorders among patients with celiac disease: A population-based national study. J Gastroenterol Hepatol. 2021;36(8):2165–70. DOI: 10.1111/jgh.15437 DOI: https://doi.org/10.1111/jgh.15437
Gholmie Y. Disordered eating attitudes and behaviors in individuals with celiac disease and the association with quality of life. US: ProQuest Information & Learning; 2021;82(11).
Fraser CN, Möller SP, Knowles SR. Understanding disease-specific and non-specific factors predicting disordered eating in adults with coeliac disease. Appetite. Department of Psychology, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Victoria, 3122, Australia: Academic Press Inc.; 2022;168:N.PAG-N.PAG. DOI: 10.1016/j.appet.2021.105744 DOI: https://doi.org/10.1016/j.appet.2021.105744
Bennett A, Bery A, Esposito P, Zickgraf H, Adams D. Avoidant/Restrictive Food Intake Disorder Characteristics and Prevalence in Adult Celiac Disease Patients. AMERICAN JOURNAL OF GASTROENTEROLOGY. Vanderbilt Univ, Med Ctr, Nashville, TN USA; 2021;116:S633-S633 WE-Science Citation Index Expanded (S. DOI: https://doi.org/10.14309/01.ajg.0000779052.19016.36
Kujawowicz K, Mirończuk-Chodakowska I, Witkowska AM. Dietary Behavior and Risk of Orthorexia in Women with Celiac Disease. Nutrients. 2022;14(4):904. DOI: 10.3390/nu14040904 DOI: https://doi.org/10.3390/nu14040904
Staller K, Abber SR, Burton Murray H. The intersection between eating disorders and gastrointestinal disorders: a narrative review and practical guide. Lancet Gastroenterol Hepatol. Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, United States: Elsevier Ltd; 2023;8(6):565–78. DOI: 10.1016/S2468-1253(22)00351-X DOI: https://doi.org/10.1016/S2468-1253(22)00351-X
Johnson JS, Cote AC, Dobbyn A, Sloofman LG, Xu J, Cotter L, et al. Mapping anorexia nervosa genes to clinical phenotypes. Psychol Med. 2023;53(6):2619–33. DOI: 10.1017/S0033291721004554 DOI: https://doi.org/10.1017/S0033291721004554
Hansen S, Osler M, Thysen SM, Rumessen JJ, Linneberg A, Kårhus LL. Celiac disease and risk of neuropsychiatric disorders: A nationwide cohort study. Acta Psychiatr Scand. Kårhus, Line Lund: Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Frederiksberg Hospital, Hovedvejen, Entrance 5, Nordre Fasanvej 57, Frederiksberg, Denmark, DK-2000, [email protected]: Wiley-Blackwell Publishing Ltd.; 2023;148(1):60–70. DOI: 10.1111/acps.13554 DOI: https://doi.org/10.1111/acps.13554
Nisihara R, Techy ACM, Staichok C, Roth TC, Biassio GF de, Cardoso LR, et al. Prevalence of eating disorders in patients with celiac disease: a comparative study with healthy individuals. Rev Assoc Med Bras (1992). 2024;70(1):e20231090–e20231090. DOI: 10.1590/1806-9282.20231090 DOI: https://doi.org/10.1590/1806-9282.20231090
Efe A, Tok A. Obsessive–compulsive symptomatology and disgust propensity in disordered eating behaviors of adolescents with celiac disease. Int J Behav Med. Efe, Ayşegül: [email protected]: Springer; 2024;31(1):85–96. DOI: 10.1007/s12529-023-10163-4 DOI: https://doi.org/10.1007/s12529-023-10163-4
Al Ibrahmi B, Bour A. Mediterranean Diet Adherence and Eating Disorders Screening in Adults with Celiac Disease in Morocco. Iran J Public Health [Internet]. Department of Biology, Faculty of Science, University Ibn Tofail, Kenitra, Morocco: Tehran University of Medical Sciences; 2024;53(8):1769–76. Recuperado: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85200726182&partnerID=40&md5=a5d531d61b67c4d58035f9500aa92c07
Rabiee R, Mahdavi R, Shirmohammadi M, Nikniaz Z. Eating disorders, body image dissatisfaction and their association with gluten-free diet adherence among patients with celiac disease. BMC Nutr. 2024;10(1):100. DOI: 10.1186/s40795-024-00910-5 DOI: https://doi.org/10.1186/s40795-024-00910-5
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