Psychological correlates of gluten-free diet adherence in adults with celiac disease.
OBJECTIVE
To determine whether personality traits and psychological characteristics are related to gluten-free diet (GFD) adherence in an adult population diagnosed with celiac disease (CD).


BACKGROUND
Little research has examined psychological correlates of adherence to the GFD.


METHODS
One hundred fifty-seven adults with biopsy-confirmed CD on the GFD for >3 months completed measures of personality and self-reported GFD adherence, provided a blood sample, and participated in an evaluation of GFD adherence conducted by an expert dietician at a clinical care center in a major teaching hospital in Boston, MA.


RESULTS
An expert evaluation of GFD adherence remained the "gold standard" for measuring GFD adherence when compared with self-report and serology. Logistic regression results indicated that the following were independently associated with GFD adherence: conscientiousness (B=-0.04, SE=0.01, P<0.00), values (B=-0.10, SE=0.05, P<0.05), other food intolerances [odds ratio=0.28, 95% confidence interval=0.10-0.78], and CD symptoms (B=0.05, SE=0.02, P<0.03). A model accounting for these associations effectively predicted whether a participant was adherent or nonadherent on the basis of psychological and demographic/disease-specific factors. Successful prediction rates of GFD adherence for the final model were 75.8% for those rated to be adherent with the GFD and 54.5% for those rated to be nonadherent with the GFD.


CONCLUSIONS
The model of psychological and demographic/disease-specific characteristics developed can be used to identify patients who may be at risk for poor dietary adherence to provide additional support, education, and encouragement to individuals with CD.
Edwards George
Jessica B
JB
Department of Gastroenterology, Beth Israel Deaconess Medical Center (BIDMC), The Celiac Center, Harvard Medical School, Northeastern University, Boston, MA02215-5491 , USA. jgeorge1@bidmc.harvard.edu
Leffler
Daniel A
DA
Dennis
Melinda D
MD
Franko
Debra L
DL
Blom-Hoffman
Jessica
J
Kelly
Ciaran P
CP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D055050:Diet, Gluten-Free / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D005512:Food Hypersensitivity; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D055815:Young Adult