Affective disorders and quality of life in adult coeliac disease patients on a gluten-free diet.
BACKGROUND
Psychiatric symptoms, common in untreated coeliac disease patients, may improve after gluten withdrawal.


OBJECTIVE
To estimate the incidence of psychiatric disorders in coeliac disease patients on gluten withdrawal and to evaluate: (1) the psychological weight of a chronic disease that involves a restrictive diet and a limited life style; (2) the acceptance of the disease; (3) the effects of both disease and diet on behaviour and quality of life.


METHODS
Three groups of 100 patients (coeliac disease patients, diabetic patients and healthy controls, respectively) were assessed by means of a professional semi-structured diagnostic interview based on DSM-IV criteria. This interview, together with specific psychiatric questionnaires, ruled out axis I or II psychopathological disturbances.


RESULTS
The modified Self-rating Depression Scale and State and Trait Anxiety Inventory Y2 scores were significantly higher in both coeliac and diabetic patients than in healthy controls. The duration of gluten restriction was related to significantly higher modified Self-rating Depression Scale scores in patients with a more recent diagnosis. Quality of life was poorer in both coeliac and diabetic patients than in healthy controls and significantly correlated with anxiety. The Illness Behaviour Questionnaire showed a high psychological and somatic perception of illness in both coeliac and diabetic patients. Its subscale scores correlated significantly with anxiety and depression symptoms.


CONCLUSIONS
In coeliac disease, affective disorders should be ascribed to difficulties in adjusting to the chronic nature of the disease rather than directly to the disease itself, thus giving an indication for preventive liaison psychiatric interventions.
Fera
Tiziana
T
Dipartimento di Neuroscienze and Dipartimento di Medicina Interna, Università degli Studi di Torino, Torino, Italy.
Cascio
Barbara
B
Angelini
Guiseppe
G
Martini
Silvia
S
Guidetti
Carla Sategna
CS
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology; D002446:Celiac Disease / Q000178:diet therapy / Q000523:psychology* / Q000534:rehabilitation; D003920:Diabetes Mellitus / Q000523:psychology; D005260:Female; D005983:Glutens / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000209:etiology*; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life
D005983:Glutens