Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): A pilot feasibility study

Deanna L. Kelly, Haley K. Demyanovich, Katrina M. Rodriguez, Daniela Čiháková, Monica V. Talor, Robert P. McMahon, Charles M. Richardson, Gopal Vyas, Heather A. Adams, Sharon M. August, Alessio Fasano, Nicola G. Cascella, Stephanie M. Feldman, Fang Liu, Mackenzie A. Sayer, Megan M. Powell, Heidi J. Wehring, Robert W. Buchanan, James M. Gold, William T. CarpenterWilliam W. Eaton

Research output: Contribution to journalArticle

Abstract

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 glutencontaining 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.

Original languageEnglish (US)
Pages (from-to)269-276
Number of pages8
JournalJournal of Psychiatry and Neuroscience
Volume44
Issue number4
DOIs
StatePublished - Jul 2019

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Pharmacology (medical)

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    Kelly, D. L., Demyanovich, H. K., Rodriguez, K. M., Čiháková, D., Talor, M. V., McMahon, R. P., Richardson, C. M., Vyas, G., Adams, H. A., August, S. M., Fasano, A., Cascella, N. G., Feldman, S. M., Liu, F., Sayer, M. A., Powell, M. M., Wehring, H. J., Buchanan, R. W., Gold, J. M., ... Eaton, W. W. (2019). Randomized controlled trial of a gluten-free diet in patients with schizophrenia positive for antigliadin antibodies (AGA IgG): A pilot feasibility study. Journal of Psychiatry and Neuroscience, 44(4), 269-276. https://doi.org/10.1503/jpn.180174