Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 14, 2010; 16(22): 2780-2787
Published online Jun 14, 2010. doi: 10.3748/wjg.v16.i22.2780
Anxiety and depression in adult patients with celiac disease on a gluten-free diet
Winfried Häuser, Karl-Heinz Janke, Bodo Klump, Michael Gregor, Andreas Hinz
Winfried Häuser, Department of Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, D-66119 Saarbrücken and Department of Psychosomatic Medicine and Psychotherapie, Technische Universität München, Langestr. 5, Germany
Karl-Heinz Janke, Baden-Württemberg State Health Office, District Government Stuttgart, Nordbahnhofstrasse 135, D-70191 Stuttgart, Germany
Bodo Klump, Gastroenterology and Gastrointestinal Cancer, St. Anna Hospital, Obere Waiblinger Starße 101, D-70374 Stuttgart, Germany and Department of Internal Medicine 1, Universitätskliniken Tübingen, Otfried-Müllerstr. 16, D-72076 Tübingen, Germany
Michael Gregor, Department of Internal Medicine 1, Universitätskliniken Tübingen, Otfried-Müllerstr. 16, D-72076 Tübingen, Germany
Andreas Hinz, Department of Medical Psychology and Medical Sociology, Universität Leipzig, Philipp-Rosenthalstr. 55, D-04103 Leipzig, Germany
Author contributions: Häuser W coordinated the surveys of celiac and inflammatory bowel disease patients; Klump B, Gregor M and Janke KH coordinated the survey of inflammatory bowel disease patients; Hinz A coordinated the general population survey; all authors were involved in performing statistical calculations and in editing the manuscript; Häuser W designed the study and wrote the manuscript; all authors approved the final version of the manuscript.
Supported by The German Ministry of Education and Research (BMBF D 20.00415) within the competence network “Inflammatory Bowel Disease” and by the German Celiac Society
Correspondence to: Winfried Häuser, MD, Department of Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, D-66119 Saarbrücken, Germany. whaeuser@klinikum-saarbruecken.de
Telephone: +49-681-9632020 Fax: +49-681-9632022
Received: January 6, 2010
Revised: March 4, 2010
Accepted: March 11, 2010
Published online: June 14, 2010
Abstract

AIM: To compare anxiety and depression levels in adult patients with celiac disease (CD) on a gluten-free diet (GFD) with controls.

METHODS: The levels of anxiety, depression and of a probable anxiety or depressive disorder were assessed by the Hospital Anxiety and Depression Scale in 441 adult patients with CD recruited by the German Celiac Society, in 235 age- and sex-matched patients with inflammatory bowel disease (IBD) in remission or with slight disease activity, and in 441 adult persons of a representative German general population sample (GP). Potential demographic (age, sex, social class, family status) and disease-related (latency to diagnosis, duration of GFD, compliance with GFD, thyroid disease) predictors of anxiety and depression in CD were tested for by regression analyses.

RESULTS: The level of anxiety in CD patients was predicted (R2 = 0.07) by female gender (P = 0.01). Female sex (OR = 3.6, 95% CI: 1.3-9.4, P = 0.01) was associated with a probable anxiety disorder. Living alone (OR = 0.5, 95% CI: 0.2-0.9, P = 0.05) was associated with a reduced risk of an anxiety disorder. The level of depression and a probable depressive disorder were not predicted by any of the demographic and medical variables tested for. The levels of anxiety in patients with CD (6.6 ± 3.4) and with IBD (6.9 ± 3.7) were higher than those of persons in the GP (4.6 ± 3.3) (both P < 0.001). The levels of depression in persons with CD (4.2 ± 3.4), IBD (4.6 ± 3.4) and of the GP (4.2 ± 3.8) did not differ (P = 0.3). The prevalence of a probable anxiety disorder in persons with CD (16.8%) and IBD (14.0%) was higher than that of the GP (5.7%) (P < 0.001). The prevalence of a probable depressive disorder did not differ significantly between the three groups (P = 0.1).

CONCLUSION: Anxiety in adult German female celiacs on a GFD is higher than in persons of the GP. Female celiacs on a GFD should be screened for anxiety.

Keywords: Celiac disease; Anxiety; Depression; Gender