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This is primarily due to the absence of specific diagnostic criteria, with most reports relying on patients\u2019 self-diagnosis. Individuals with NCGS experience intestinal (abdominal pain, bloating, diarrhea, or constipation) and extraintestinal symptoms (\u201cfoggy mind,\u201d depression, anxiety, and deterioration of psychiatric conditions) after gluten consumption. Frequent disregard and oversight of extraintestinal manifestations, such as psychiatric symptoms, further complicates NCGS. The lack of understanding about NCGS causes individuals living with this condition to experience distress, frustration, and stigmatization. An impaired intestinal barrier, gut dysbiosis, and alterations in the gut\u2013brain axis are proposed as key factors in the NCGS and psychiatric symptoms associated with NCGS. None of these links are yet definitive, and the methodological limitations of existing studies\u2014small samples, self-reported diagnoses, and insufficient blinding\u2014demand that conclusions be drawn with appropriate restraint. The purpose of this review is to provide an up-to-date understanding of the pathophysiology of NCGS and psychiatric symptoms associated with NCGS. Future studies should focus on development of reliable, objective diagnostic markers for NCGS and on the design of adequately powered, double-blind, placebo-controlled trials that incorporate validated psychiatric outcome measures alongside intestinal indices.<\/jats:p>","DOI":"10.3390\/nu18142272","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T08:05:31Z","timestamp":1783929931000},"page":"2272","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychiatric Symptoms Associated with Non-Celiac Gluten Sensitivity: A Focused Narrative Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7474-7495","authenticated-orcid":false,"given":"Dragica","family":"Pavlovic","sequence":"first","affiliation":[{"name":"Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"},{"name":"Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8151-9004","authenticated-orcid":false,"given":"Marina","family":"Gazdic Jankovic","sequence":"additional","affiliation":[{"name":"Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragana","family":"Papic","sequence":"additional","affiliation":[{"name":"Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"},{"name":"Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7238-7414","authenticated-orcid":false,"given":"Nikolina","family":"Kastratovic","sequence":"additional","affiliation":[{"name":"Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"},{"name":"Center for Harm Reduction of Biological and Chemical Hazards, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3269-1577","authenticated-orcid":false,"given":"Nikola","family":"Jovic","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"},{"name":"Clinic of Gynecology and Obstetrics, University Clinical Center Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Protrka","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, University Clinical Centre Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6072-085X","authenticated-orcid":false,"given":"Vladimir","family":"Janjic","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"},{"name":"Psychiatry Clinic, University Clinical Center Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6759-2720","authenticated-orcid":false,"given":"Biljana","family":"Ljujic","sequence":"additional","affiliation":[{"name":"Department of Genetics, Faculty of Medical Sciences, University of Kragujevac, 69 Svetozar Markovic Street, 34000 Kragujevac, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1080\/07853890.2017.1325968","article-title":"Gluten-Related Disorders: Certainties, Questions and Doubts","volume":"49","author":"Valenti","year":"2017","journal-title":"Ann. 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