Psychoneurotic symptoms and alexithymia in coeliac disease.
OBJECTIVE
Depression, psychological problems and the impairment of quality of life are reported to occur in untreated coeliac disease. Alexithymia ("no words for feelings") is associated with various gastrointestinal disorders. The aim of this study was to evaluate whether patients with coeliac disease suffer from psychoneurotic symptoms or alexithymia, and whether a gluten-free diet has an impact on the symptoms.


METHODS
The Crown-Crisp Experiential Index (CCEI) and its six subscales were applied to measure neurotic psychopathology, and the 20-item version of the Toronto Alexithymia Scale (TAS-20) and its 3-factor scales to measure alexithymia. The testing was carried out in 20 consecutive adult patients with biopsy-proven coeliac disease before and after one year of treatment on a gluten-free diet. The data were compared with those obtained earlier in non-coeliac Finnish subjects.


RESULTS
Somatic anxiety was higher in coeliac disease patients before the introduction of the gluten-free diet than after adhering to the diet. Otherwise, the diet had no significant impact on the CCEI scores. The patients were not suffering from alexithymia, but the TAS-20 score improved significantly during the follow-up. The scores did not differ from those published in the Finnish population.


CONCLUSIONS
Psychological problems were not common in adult coeliac disease patients. Gluten-free diet had only a minor influence on the symptoms. Common knowledge about coeliac disease and the readily available gluten-free products may have had an impact on these results.
Collin
Pekka
P
Department of Gastroenterology and Alimentary Tract Surgery, Medical School, Tampere University Hospital, Tampere, Finland. pekka.collin@uta.fi
Kaukinen
Katri
K
Mattila
Aino K
AK
Joukamaa
Matti
M
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000178:diet therapy / Q000209:etiology*; D000368:Aged; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy* / Q000523:psychology*; D055050:Diet, Gluten-Free; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000178:diet therapy* / Q000209:etiology; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D055815:Young Adult