Psychological support counselling improves gluten‐free diet compliance in coeliac patients with affective disorders

Abstract

Summary Background : Anxiety and depression are common features of coeliac disease. Depression is cause of non‐compliance to treatment in chronic illness. Aim : To evaluate the useful of psychological support counselling to improve affective disorders and gluten‐free diet adherence in coeliac disease with anxiety and depression. Methods : A total of 66 coeliac disease patients with state anxiety and current depression were enrolled. Patients were randomized in two groups: in group A psychological support was started at the beginning of gluten‐free diet, while group B was free of psychological support. Both groups were followed every 2 weeks for 6 months. State and Trait Anxiety Inventory test Y‐1 and the modified Zung self‐rating depression scale were administered before (T0) and after 6 months of gluten‐free diet (T1). Results : At T1 no difference was found between groups in the percentage of state anxiety, while a significant lower percentage of depressed subjects was found in group A with respect to group B (15.1% vs. 78.8%; P = 0.001). In the follow‐up period, a significant lower compliance to gluten‐free diet was found in group B with respect to group A (39.4% vs. 9.1%; P = 0.02). Conclusions : In coeliac disease patients with affective disorders psychological support seems to be able to reduce depression and to increase gluten‐free diet compliance.

The psychosocial impacts caused by diagnosis and treatment of Coeliac Disease

“…These finding comply with studies done in Italy (17)(18)(19) and in Sweden (20) , which show that gluten holds high value in society in general and that effective treatment, aiming the subject's quality of life, must be amplified to all spectrums experienced daily by the patient, understanding the necessary care with something further than serologic and histologic control reaching psychological treatment.…”

The relationship between gluten free diet adherence and depressive symptoms in adults with coeliac disease: A systematic review with meta-analysis

“…Based on these tentative findings, there may be a role for psychological services in addition to dietetic input in the ongoing management and follow-up of GFD adherence for affected CD patients (Ludvigsson et al, 2014;NICE, 2015), even in cases of low-level, subclinical depressive symptoms (NICE, 2009). Online and face-to-face interventions using both individual and group-based formats have shown promise in improving GFD adherence and psychological wellbeing in CD (Addolorato et al, 2004;Ring Jacobsson, Friedrichsen, Goransson, & Hallert, 2012;Sainsbury, Mullan, & Sharpe, 2013c), and could help to achieve needed improvements in both directions. Higher depression scores were associated with poorer adherence (r = 0.48, p < .001).…”

Psychological morbidity of celiac disease: A review of the literature

“…This has been suggested in a 2004 study by Addolorato et al, which showed a beneficial effect of psychological support for CD patients on a GFD both in relation to psychological disorders and to improved dietary adherence. 59 Fera et al, 60 in a study of 100 patients treated for eight years, found a high rate of depression, detected by the modified Self-Rating Depression Scale, which tended to improve with time, but which was not correlated with dietary compliance. Similarly, a 2013 cross-sectional study, 61 reporting a self-reported depression prevalence of 39% among 2265 adult CD patients (based on the Major Depression Questionnaire), described that the longterm adherence to the GFD (>5 years) was associated with a reduced risk of depression, but they found no association between insufficient adherence and current depression symptoms.…”