title: Coeliac disease, diet adherence and depressive symptoms.
abstract: OBJECTIVE
  We aimed to investigate whether long-term adherence to a gluten-free diet is related to depressive symptoms in coeliac disease (CD) patients.
  
  
  METHODS
  A cross-sectional survey was performed in 2265 adult CD patients recruited through the Dutch Coeliac Association. Self-reported diet adherence was compared among groups based on self-reported depressive symptoms (categorized into current [1-month], remitted, and never).
  
  
  RESULTS
  The life-time prevalence rate of self-reported depressive symptoms was 39.0% (n=883), of whom 270 (11.9%) suffered from current depressive symptoms. Adherence to gluten-free diet was strict in 50.2% of patients, sufficient in 46.3%, and insufficient in 3.6%. Insufficient adherence was not associated with current depressive symptoms (odds ratio [OR] 0.95; 95% confidence interval [CI]: 0.48-1.92). Keeping a gluten-free diet for longer than five years was associated with lower OR of current depressive symptoms compared to being on a diet for less than two years (OR 0.69; 95% CI: 0.50-0.95).
  
  
  CONCLUSIONS
  Lifetime depressive symptoms may be present in one third of the CD patients who adhere to gluten-free diet. Long-term adherence to the gluten-free diet may reduce the risk of current depressive symptoms.
authors: Institute of Psychology, Leiden University, Leiden, The Netherlands. heesnjmvan@fsw.leidenuniv.nl
authors: Nathalie J M
authors: NJ
authors: van Hees
authors: Willem
authors: W
authors: Van der Does
authors: Erik J
authors: EJ
authors: Giltay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000178:diet therapy / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D055050:Diet, Gluten-Free / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D015995:Prevalence; D011795:Surveys and Questionnaires