Psychological morbidity of celiac disease: A review of the literature.
BACKGROUND
Celiac disease has been linked to decreased quality of life and certain mood disorders. The effect of the gluten free diet on these psychological aspects of the disease is still unclear.


OBJECTIVE
The objective of this article is to review the literature on psychological morbidity of celiac disease.


METHODS
We performed a PubMed search for the time period from 1900 until June 1, 2014, to identify papers on psychological aspects of celiac disease looking specifically at quality of life, anxiety, depression and fatigue.


RESULTS
Anxiety, depression and fatigue are common complaints in patients with untreated celiac disease and contribute to lower quality of life. While aspects of these conditions may improve within a few months after starting a gluten-free diet, some patients continue to suffer from significant psychological morbidity. Psychological symptoms may affect the quality of life and the dietary adherence.


CONCLUSIONS
Health care professionals need to be aware of the ongoing psychological burden of celiac disease in order to support patients with this disease.
University of Salerno, Department of Medicine and Surgery, Salerno, Italy.
Fabiana
F
Zingone
Department of Gastroenterology, University Hospital Llandough, Cardiff, Wales, UK.
Gillian L
GL
Swift
Division of Epidemiology and Public Health, The University of Nottingham, Nottingham City Hospital, Nottingham, UK.
Timothy R
TR
Card
Department of Gastroenterology, Royal Hallamshire Hospital & the University of Sheffield, UK.
David S
DS
Sanders
Department of Pediatrics, Örebro University Hospital, Örebro; and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Jonas F
JF
Ludvigsson
Department of Medicine, "C. Bonorino Udaondo" Gastroenterology Hospital, Universidad del Salvador, Buenos Aires, Argentina.
Julio C
JC
Bai
Celiac disease; anxiety; depression; fatigue; quality of life