Psychological support counselling improves gluten-free diet compliance in coeliac patients with affective disorders.
BACKGROUND
Anxiety and depression are common features of coeliac disease. Depression is cause of non-compliance to treatment in chronic illness.


OBJECTIVE
To evaluate the useful of psychological support counselling to improve affective disorders and gluten-free diet adherence in coeliac disease with anxiety and depression.


METHODS
A total of 66 coeliac disease patients with state anxiety and current depression were enrolled. Patients were randomized in two groups: in group A psychological support was started at the beginning of gluten-free diet, while group B was free of psychological support. Both groups were followed every 2 weeks for 6 months. State and Trait Anxiety Inventory test Y-1 and the modified Zung self-rating depression scale were administered before (T0) and after 6 months of gluten-free diet (T1).


RESULTS
At T1 no difference was found between groups in the percentage of state anxiety, while a significant lower percentage of depressed subjects was found in group A with respect to group B (15.1% vs. 78.8%; P=0.001). In the follow-up period, a significant lower compliance to gluten-free diet was found in group B with respect to group A (39.4% vs. 9.1%; P=0.02).


CONCLUSIONS
In coeliac disease patients with affective disorders psychological support seems to be able to reduce depression and to increase gluten-free diet compliance.
Addolorato
G
G
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy. g.addolorato@rm.unicatt.it
De Lorenzi
G
G
Abenavoli
L
L
Leggio
L
L
Capristo
E
E
Gasbarrini
G
G
D000328:Adult; D001008:Anxiety Disorders / Q000150:complications*; D002446:Celiac Disease / Q000178:diet therapy* / Q000523:psychology; D003376:Counseling; D003866:Depressive Disorder / Q000150:complications*; D018753:Diet, Protein-Restricted / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012944:Social Support