Researchers from Spain conducted a study on adults with newly diagnosed celiac disease to evaluate (using a Gastrointestinal Symptom Rating Scale and a Psychological General Well-being Index) psychological alterations (emotional “distress”), the association between these alterations and gastrointestinal symptoms, and improvement on gluten-free diet. Patients were given a nutritional assessment before beginning a gluten-free diet, and were followed up 6 months later. It was determined that many patients did experience emotional distress to various degrees, more severe distress occurred for patients with more severe gastrointestinal symptoms. Fortunately, patients’ psychological well-being improved when gastrointestinal symptoms improved after starting the gluten-free diet.
Patients with recently-diagnosed adult celiac disease were evaluated with the Gastrointestinal Symptom rating Scale (GSRS) and Psychological General Well-Being Index (PGWBI) to evaluate their psychological alterations, the association between any alterations and gastrointestinal symptoms, and their outcome after starting a gluten-free diet. The patients underwent nutritional assessment and then started a gluten-free diet; they were reassessed 6 months later. Quantitative variables are expressed as the median and 25th-75th percentiles.
We included 21 patients, 17 women and 4 men, with a mean age of 43 years (31-47). The results of histological analysis were compatible with Marsh I lesions in 6 patients, Marsh IIIa in 6 and Marsh IIIb in 9. At baseline, 8 patients showed severe psychological distress, 4 showed moderate distress and 9 showed no distress. The GSRS score was 34 (17-43) and the PGWBI was 64 (48-87), with a significant correlation between the 2 indexes (rho=-.58, P=.006). At 6 months, 3 patients had severe psychological distress, 5 had moderate distress, 9 showed no distress and 4 showed psychological well-being. The GSRS score at 6 months was 13 (8-17) and the PGWBI was 83 (68-95) (P<.05 compared with baseline data for the 3 indicators). The 6 axes of the PGWBI showed significant improvement. At 6 months, no correlation was found between the GSRS and PGWBI.
Patients with celiac disease have psychological alterations whose intensity is related to gastrointestinal symptoms. These symptoms improve after the start of a gluten-free diet.
For author information, review Abstract published on PubMed.com HERE.