title: [Psychological alterations in patients with adult celiac disease].
abstract: Patients with recently-diagnosed adult celiac disease were evaluated with the Gastrointestinal Symptom rating Scale (GSRS) and Psychological General Well-Being Index (PGWBI) to evaluate their psychological alterations, the association between any alterations and gastrointestinal symptoms, and their outcome after starting a gluten-free diet. The patients underwent nutritional assessment and then started a gluten-free diet; they were reassessed 6 months later. Quantitative variables are expressed as the median and 25th-75th percentiles.
  
  
  RESULTS
  We included 21 patients, 17 women and 4 mena, with a mean age of 43 years (31-47). The results of histological analysis were compatible with Marsh I lesions in 6 patients, Marsh IIIa in 6 and Marsh IIIb in 9. At baseline, 8 patients showed severe psychological distress, 4 showed moderate distress and 9 showed no distress. The GSRS score was 34 (17-43) and the PGWBI was 64 (48-87), with a significant correlation between the 2 indexes (rho=-.58, P=.006). At 6 months, 3 patients had severe psychological distress, 5 had moderate distress, 9 showed no distress and 4 showed psychological well-being. The GSRS score at 6 months was 13 (8-17) and the PGWBI was 83 (68-95) (P<.05 compared with baseline data for the 3 indicators). The 6 axes of the PGWBI showed significant improvement. At 6 months, no correlation was found between the GSRS and PGWBI.
  
  
  CONCLUSIONS
  Patients with celiac disease have psychological alterations whose intensity is related to gastrointestinal symptoms. These symptoms improve after the start of a gluten-free diet.
authors.affiliation: Unidad de Enfermedad Celíaca, Servicios de Aparato Digestivo, Pediatría, Nutrición y Dietética, Anatomía Patológica y Análisis Clínicos, Hospital Universitari Sant Joan de Reus, Tarragona, España. Electronic address: martinez@comll.cat.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Martínez Cerezo
authors.affiliation: Unidad de Enfermedad Celíaca, Servicios de Aparato Digestivo, Pediatría, Nutrición y Dietética, Anatomía Patológica y Análisis Clínicos, Hospital Universitari Sant Joan de Reus, Tarragona, España.
authors.forename: Gemma
authors.initials: G
authors.lastname: Castillejo
authors.affiliation: Unidad de Enfermedad Celíaca, Servicios de Aparato Digestivo, Pediatría, Nutrición y Dietética, Anatomía Patológica y Análisis Clínicos, Hospital Universitari Sant Joan de Reus, Tarragona, España.
authors.forename: Núria
authors.initials: N
authors.lastname: Guillen
authors.affiliation: Unidad de Enfermedad Celíaca, Servicios de Aparato Digestivo, Pediatría, Nutrición y Dietética, Anatomía Patológica y Análisis Clínicos, Hospital Universitari Sant Joan de Reus, Tarragona, España.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Morente
authors.affiliation: Unidad de Enfermedad Celíaca, Servicios de Aparato Digestivo, Pediatría, Nutrición y Dietética, Anatomía Patológica y Análisis Clínicos, Hospital Universitari Sant Joan de Reus, Tarragona, España.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Simó
authors.affiliation: Unidad de Enfermedad Celíaca, Servicios de Aparato Digestivo, Pediatría, Nutrición y Dietética, Anatomía Patológica y Análisis Clínicos, Hospital Universitari Sant Joan de Reus, Tarragona, España.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Tena
authors.affiliation: Unidad de Enfermedad Celíaca, Servicios de Aparato Digestivo, Pediatría, Nutrición y Dietética, Anatomía Patológica y Análisis Clínicos, Hospital Universitari Sant Joan de Reus, Tarragona, España.
authors.forename: Joan
authors.initials: J
authors.lastname: Marsal
authors.affiliation: Unidad de Enfermedad Celíaca, Servicios de Aparato Digestivo, Pediatría, Nutrición y Dietética, Anatomía Patológica y Análisis Clínicos, Hospital Universitari Sant Joan de Reus, Tarragona, España.
authors.forename: Domingo
authors.initials: D
authors.lastname: Pascual
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000178:diet therapy / Q000473:pathology / Q000523:psychology*; D003863:Depression / Q000209:etiology; D055050:Diet, Gluten-Free / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D011788:Quality of Life; D012649:Self Concept; D020377:Self Efficacy; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000209:etiology; D063189:Symptom Assessment; D016896:Treatment Outcome
keywords: Ansiedad; Anxiety; Celiac disease; Depresión; Depression; Digestive signs and symptoms; Enfermedad celiaca; Medical psychology; Psicología médica; Psychological tests; Signos y síntomas digestivos; Test psicológicos