Psychological Dimensions of Celiac Disease: Toward an Integrated Approach

Authors: Ciacci C.¹; Iavarone A.^{2, 3}; Siniscalchi M.⁴; Romano R.¹; Rosa A.D.⁵

Source: Digestive Diseases and Sciences, Volume 47, Number 9, September 2002 , pp. 2082-2087(6)

Publisher: Springer

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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.

Keywords: celiac disease; follow-up; psychology; emotional impact; intestine; gluten-free diet; adults

Language: English

Document Type: Research article

Affiliations: 1: Cattedra di Gastroenterologia, Università di Napoli “Federico II”, Naples, Italy 2: Divisione di Neurologia–Ospedale CTO, Azi 3: 4: Corso di Laurea in Psicologia, II Università di Napoli, Via Vivaldi, Caserta, Naples, Italy 5: Servizio di Psicoterapia, Seconda Università di Napoli, Naplos, Italy

Publication date: 2002-09-01

Psychological Dimensions of Celiac Disease: Toward an Integrated Approach

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