Abstract
Psychic alterations have been reported in celiac disease. Our aim was to evaluate the emotional impact of celiac disease diagnosis in adulthood, the patient/doctor relationship, and the patients' cooperation with disease treatment and diet. The patients were 114 adult celiac patients on a gluten-free diet, there were 25 untreated celiac patients. Self-administered questionnaires aimed to evaluate the patients' level of knowledge of disease, the emotional impact at diagnosis, and feelings during follow-up. Celiac patients showed good knowledge of the disease, directly correlated to their socioeconomic level (P = 0.011). At diagnosis, relief was most intense feeling (Mean ± SD, 10.82 ± 7.63), demographics, time latency of diagnosis, and the duration of the disease had no effect on the intensity of all feelings. The scores of the self-rated emotions were entered into a principal component analysis that generated three factors: 1 (fear, anger, anxiety and sadness), 2 (reassurance and resignation), and 3 (relief); patients judged the clinicians presenting the disease “in the right way” (F = 33.279; P < 0.0001). The right way correlated with relief and reassurance (P = 0.0009; P = 0.0008 respectively). At follow-up, anger was the predominant emotion that induced patients to transgress. A positive correlation was observed between feeling different and the sadness, anger, fear (P < 0.0001 for all). Anger was inversely correlated with actual compliance to diet (P = 0.0005). In conclusion, in adult patients, adaptive and psychological aspects must be taken into account to understand the celiac patient and for better clinical management.
Similar content being viewed by others
REFERENCES
Cooke WT, Holmes GKT: Celiac Disease. Edinburgh, Churchill Livingstone; 1984, pp. 157–160
Marsh MN: Celiac Disease. Oxford, Blackwell Scientific Publications, 1992
Corazza GR, Frisoni M, Treggiari EA, Valentini RA, Filipponi C, Volta U, Gasbarrini G: Subclinical celiac sprue: Increasing occurrence and clues to its diagnosis. J Clin Gastroenterol 16:16–21, 1993
Ciacci C, Cirillo M, Sollazzo R, Savino G, Sabbatini F, Mazzacca G: Gender and clinical presentation in adult celiac disease. Scand J Gastroenterol 30:1077–1081, 1995
Catassi C, Ratsch IM, Fabiani E, Bordicchia F, Candela F, Coppa GV, Giorgi PL: Celiac disease in the year 2000: exploring the iceberg. Lancet 343:200–203, 1994
Hallert C, Derefeldt T: Psychic disturbances in adult celiac disease. I. Clinical observations. Scand J Gastroenterol 17(1):17–19, 1982
Hallert C, Astrom J: Psychic disturbances in adult celiac disease II. Psychological findings. Scand J Gastroenterol 17(1):21–24, 1982
Hallert C, Astrom J, Sedvall G: Psychic disturbances in adult celiac disease. III. Reduced central monoamine metabolism and signs of depression. Scand J Gastroenterol 17(1):25–28, 1982
Hernanz A, Polanco I: Plasma precursor amino acids of central nervous system monoamines in children with celiac disease. Gut 32(12):1478, 1991
Goldberg D: A psychiatric study of patients with diseases of the small intestine. Gut 11(6):459–465, 1970
Pellegrino M, D'Altilia MR, Germano M: Untreated celiac disease and attempted suicide. Lancet 346(8979):915, 1995
Ciacci C, De Rosa A, de Michele G, Savino G, Squillante A, Iovino P, Sabbatini F, Mazzacca G: Sexual behaviour in untreated and treated celiac patients. Eur J Gastroenterol Hepatol 10(8):649–651, 1998
Addolorato G, Stefanini GF, Capristo E, Caputo F, Gasbarrini A, Gasbarrini G: Anxiety and depression in adult untreated celiac subjects and in patients affected B inflammatory bowel disease: A personality “trait” or reactive illness? Heptogastroenterology 43(12):1513–1517, 1996
Corvaglia L, Catamo R, Pepe G, Lazzari R, Corvaglia E: Depression in adult untreated celiac subjects: Diagnosis by the pediatrician. Am J Gastroenterol 94(3):839–843, 1999
Kokkonen J, Viitanen A, Simila S: Coping with a celiac diet after adolescence. Helv Pediatr Acta 43:261–265, 1989
Bentley AC: A survey of celiac-sprue patients: Effect of dietary restrictions on religious practices. J Gen Psychol 115(1):7–14, 1988
Hallert C, Grännö C, Grant C, Hultén G, Midaghen G, Strö M, Svensson H, Valdimarsson T, Wickström T: Quality of life of adult celiac patients treated for 10 years. Scand J Gastroenterol 33:933–938, 1998
Hallert C, Lohiniemi S: Quality of life of celiac patients living on a gluten-free diet Nutrition 15(10):795–797, 1999
Ciacci C, Iavarone A, Mazzacca G, De Rosa A: Depressive symptoms in adult celiac disease. Scand J Gastroenterol 33(3):247–250, 1998
Drossman DA, McKee DC, Sandler RS, Mitchell CM, Cramer EM, Lowman BC, et al: Psychosocial factors in the irritable syndrome. A multivariate study of patients and and nonpatients with irritable bowel syndrome. Gastroenterology 95:709–714, 1998
Pilowsky I, Spence ND: Patterns of illness behaviour in patients with intractable pain. J Psychosom Res 19:279–287, 1975
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ciacci, C., Iavarone, A., Siniscalchi, M. et al. Psychological Dimensions of Celiac Disease: Toward an Integrated Approach. Dig Dis Sci 47, 2082–2087 (2002). https://doi.org/10.1023/A:1019637315763
Issue Date:
DOI: https://doi.org/10.1023/A:1019637315763