title: The Burden of Depressive and Bipolar Disorders in Celiac Disease.
abstract: BACKGROUND
  
  
  
  OBJECTIVE
  to measure the association between Celiac Disease (CD) and affective disorders, particularly Bipolar Disorder (BD), since it has not been studied yet, and to measure how much the quality of life (QoL) of a person with CD is affected by comorbidity with these disorders.
  
  
  METHODS
  
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  60 consecutive patients with CD.
  
  
  METHODS
  240 subjects without CD, randomly selected after sex- and age-matching from a database of an epidemiological study. Psychiatric diagnoses according to DSM-IV carried out by physicians using structured interview tools (ANTAS-SCID). QoL was measured by means of SF-12.
  
  
  RESULTS
  The lifetime prevalence of Major Depressive Disorder (MDD) was higher in CD than in controls (30.0% vs 8.3%, P<0.0001) as well as Panic Disorder (PD) (18.3% vs 5.4%, P<0.001) and BD (4.3% vs 0.4%, P<0.005). Patients with CD show a lower mean score than controls on SF12 (35.8±5.7 vs. 38.2±6.4; p=0.010), but those without comorbidity with MDD, PD and BD do not. The attributable burden of CD in worsening QoL - when comorbid with these disorders - was found comparable to that of serious chronic diseases like Wilson's Disease, and lower than Multiple Sclerosis only.
  
  
  CONCLUSIONS
  MDD, PD and BD are strictly associated with CD. The comorbidity with these disorders is the key determinant of impaired quality of life in CD. Thus a preventive action on mood and anxiety disorders in patients suffering from CD is required. Moreover a screening for CD in people with affective disorders and showing key symptoms or family history of CD is recommended.
authors.affiliation: Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Mauro Giovanni
authors.initials: MG
authors.lastname: Carta
authors.affiliation: Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Conti
authors.affiliation: Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Lecca
authors.affiliation: Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Sancassiani
authors.affiliation: Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Cossu
authors.affiliation: Department of Medicine "Mario Aresu", University of Cagliari, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Carruxi
authors.affiliation: Department of Medicine "Mario Aresu", University of Cagliari, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Boccone
authors.affiliation: Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Cadoni
authors.affiliation: Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Pisanu
authors.affiliation: Department of Public Health Clinical and Molecular Medicine, University of Cagliari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Francesca Moro
authors.affiliation: Department of Medicine "Mario Aresu", University of Cagliari, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Demelia
keywords: Attributable burden; bipolar disorder; case control study; celiac disease; depressive disorder; quality of life.