Table 1.
Previous literature on depression and anxiety in CD
| First author, year of publication | Study population | Outcomes measured | Conclusions |
|---|---|---|---|
| Addolorato, 199650 | 16 celiac patients 16 IBD 16 Healthy controls | STAI test Ipat Depression Scale Questionnaire | “State” anxiety in celiac patients and IBD patients was increased compared to healthy controls but no increase in personality ‘trait’ anxiety that was present in a similar percentage in all the participants evaluated. Depressive syndrome was more frequent in celiac patients than healthy control group. |
| Ciacci, 199871 | 92 Celiac patients 100 Healthy controls 48 Patients with CPH | MSDS | Depressive disorder was more frequent in celiac patients than in healthy controls and CPH patients. Age at CD diagnosis, duration of GFD and compliance with diet did not correlate with depression. |
| Addolorato, 200151 | 35 Celiac patients before (T0) and one year after GFD. 59 Healthy controls | STAI test MSDS | At T0 celiac patients showed high levels of state anxiety and depression compared to controls. After one year of GFD state anxiety decreased significantly but depression did not. |
| Hallert, 200211 | 68 Celiac patients on GFD Matched type-2 DM patients | Nine-item Burden of illness protocol (perceived worries, restrictions and subjective outcome) SF36 | Women with CD perceived the health burden to be worse than men and expressed more concern about the impact of socializing with friends. |
| Carta, 200267 | 36 Celiac patients 144 Healthy controls | International composite Diagnostic Interview for psychiatric diagnoses based on DSM-IV criteria. | CD patients tended to show higher prevalence of panic disorder and major depressive disorder. Thyroid disease appears to present a significant risk factor for these conditions. |
| Fera, 200360 | 100 Celiac patients on GFD 100 Healthy controls 100 DM patients | Professional semi-structured diagnostic interview based on DSM-IV criteria MSDS, STAI test, SF36, IBQ | Depression and anxiety were common features among celiac patients, these disorders tend to improve with the time and they did not depend on diet compliance or demographic variables; Depression and anxiety disorders are significantly higher in both celiac and diabetic patients than healthy controls. |
| Ciacci, 200313 | 581 Celiac patients on GFD | MSDS, VAS for the evaluation of anxiety, depression, and positive attitude | Most patients (83.6%) felt “very well” and “well.” Celiac women and patients diagnosed after 20 years of age have better dietary adherence, but more problems in their social life. Anxiety was related to feeling different from the general population and depression to an unsatisfactory sexual life. |
| Siniscalchi, 200558 | 71 Celiac patients at diagnosis 59 Celiac patients on GFD 80 Healthy controls | MSDS, CFS questionnaire, FSS, VAS for the evaluation of fatigue | Fatigue and depression symptoms were more frequent in celiac patients than controls. Patients on GFD showed more frequent and severe symptoms of depression than patients at diagnosis. |
| Ludvigsson, 200770 | 13,776 Celiac patients 66,815 Healthy controls | Celiac patients with mood disorders and bipolar disorders found through the Swedish National Inpatient Register | CD was associated with an increased risk of subsequent depression (Hazard ratio = 1.8) but it was not associated with subsequent bipolar disorders. Individuals with depression had an increased risk of CD. |
| Addolorato, 200853 | 40 Celiac patients on GFD 50 Healthy controls | Social Phobia assessed by Liebowitz Social Anxiety Scale MSDS | Social phobia and depression were significantly greater in CD patients than controls. |
| Garud, 200968 | 600 Celiac patients (mixed) 200 Healthy controls 200 IBS patients | The diagnosis of psychiatric disorders including depression is made from primary care provider notes and gastroenterologist notes. | The prevalence of depression in celiac patients was 17.2% and was similar to those in IBS patients (18.5%) and in controls (16.0%). Among CD patients, depression was more frequent in celiac patients with DM type 1. |
| Nachman, 201044 | 53 Celiac patients before (T0) and after one year and four years of GFD | SF36, BDI | At four years, the SF36 and BDI scores showed a significant deterioration compared with one year, but these scores remained significantly better than those at diagnosis. The significant deterioration of scores at four years was related to the lack of adherence to the GFD. |
| Zingone, 201057 | 30 Celiac patients at diagnosis 30 Celiac patients on GFD 30 Healthy controls | PSQI, MSDS, STAI test, SF36, VAS for the evaluation of fatigue | Sleep disorders were common in celiac patients at diagnosis and on GFD. Depression, fatigue and anxiety in celiac patients did not improve on GFD. Sleep disorders were directly correlated with the mood disorders. |
| Häuser, 201052 | 441 Celiac patients on GFD 235 IBD patients 441 Healthy controls | HADS | Levels of anxiety were greater in CD and IBD patients than controls. Levels were greater in females than males. Levels of depression did not differ among the three groups. |
| van Hees, 201361 | 2,265 Adult patients on GFD | HADS, Major Depression Questionnaire, self-report Leiden Index of Depression Sensitivity (short version) | Depression symptoms were present in 39% of CD patients. Long-term GFD (over five years) was associated with a reduced risk of depression. No association between compliance to GFD and depression. |
BDI: Beck Depression Inventory; CD: celiac disease; CFS: chronic fatigue syndrome; CPH: chronic persistent hepatitis; FSS: Fatigue Severity Scale; GP: general practice; GFD: gluten-free diet; HADS: Hospital Anxiety and Depression Scale; IBQ: Illness Behavior Questionnaire; IBD: inflammatory bowel disease; IBS: irritable bowel syndrome; MSDS: Modified Zung self-rating Depression Scale; PSQI: Pittsburgh Sleep Quality Index; SF36: Short Form 36 Health Survey; STAI: State & Trait Anxiety Inventory; DM: diabetes mellitus; DSM-IV: Diagnostic and Statistical Manual of Mental Disorders, 4th ed.