RT Journal Article
SR Electronic
T1 Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): a pilot feasibility study
JF Journal of Psychiatry and Neuroscience
JO J Psychiatry Neurosci
FD Canadian Medical Association
SP 269
OP 276
DO 10.1503/jpn.180174
VO 44
IS 4
A1 Deanna L. Kelly
A1 Haley K. Demyanovich
A1 Katrina M. Rodriguez
A1 Daniela Čiháková
A1 Monica V. Talor
A1 Robert P. McMahon
A1 Charles M. Richardson
A1 Gopal Vyas
A1 Heather A. Adams
A1 Sharon M. August
A1 Alessio Fasano
A1 Nicola G. Cascella
A1 Stephanie M. Feldman
A1 Fang Liu
A1 MacKenzie A. Sayer
A1 Megan M. Powell
A1 Heidi J. Wehring
A1 Robert W. Buchanan
A1 James M. Gold
A1 William T. Carpenter, Jr.
A1 William W. Eaton
YR 2019
UL http://jpn.ca/content/44/4/269.abstract
AB Background: Approximately one-third of people with schizophrenia have elevated levels of antigliadin antibodies of the immunoglobulin G type (AGA IgG) — a higher rate than seen in healthy controls. We performed the first double-blind clinical trial of gluten-free versus gluten-containing diets in a subset of patients with schizophrenia who were positive for AGA IgG.Methods: In this pilot feasibility study, 16 participants with schizophrenia or schizoaffective disorder who had elevated AGA IgG (≥ 20 U) but were negative for celiac disease were admitted to an inpatient unit for a 5-week trial. All participants received standardized gluten-free meals and were randomized in a double-blind fashion to receive a shake containing 10 g of gluten flour or 10 g of rice flour each day. Participants were rated for psychiatric, cognitive and gastrointestinal symptoms at baseline and end point.Results: Of the 16 participants, 14 completed the 5-week trial (2 discontinued early for administrative reasons). Compared with participants on the gluten-containing diet, participants on the gluten-free diet showed improvement on the Clinical Global Impressions scale (Cohen d = −0.75) and in negative symptoms (Cohen d = −0.53). We noted no improvement in positive or global cognitive symptoms, but did observe an improvement in attention favouring the gluten-free diet (Cohen d = 0.60). Robust improvements in gastrointestinal adverse effects occurred in the gluten-free group relative to the gluten-containing group. Adverse effects were similar between groups.Limitations: This study was limited by its small sample size; larger studies are needed.Conclusion: This feasibility study suggests that removal of gluten from the diet is associated with improvement in psychiatric and gastrointestinal symptoms in people with schizophrenia or schizoaffective disorder.