Depression greatly affects quality of life in patients with celiac disease

Depressive symptoms in youngsters with celiac disease (CD) account for low quality of life (QOL) at adolescence, but disease-related lifestyle adjustments, such as following a limited diet, are not related to reduced QOL. That surprising finding arose from a prospective survey of 12- to 18-year-old patients with CD and their caregivers, who completed standard measures of adjustment to CD depression, and QOL. Depression was the only statistically significant correlate of QOL in the study’s 105 patients.

Although both patients and parents reported high levels of depression symptoms in the patients, no associations were found between QOL and age, duration of CD, duration of time on a gluten-free diet, or current symptoms. Investigators also found that depression scores in teenagers with CD are high and comparable with those reported by psychiatric clinics of adolescents who received diagnoses of mental health disorders. Identifying and addressing these symptoms may improve adherence to dietary guidelines for CD, the investigators noted. In addition, because high rates of depression may affect CD prognosis, screening for depression in these adolescent patients appears critical, according to the authors.

Thoughts from Dr. Farber

Depression is common in chronic disease, and we should always be on the lookout for it. The results of this study showed that, unlike with other diseases, “worse” CD was not a significant factor, suggesting that depression was more likely to be primary rather than caused by having a chronic illness. As such, “improving” the disease would not be expected to improve depression.

Reference

1. Jericho H, Khan N, Cordova J, Sansotta N, Guandalini S, Keenan K. Call for action: high rates of depression in the pediatric celiac disease population impacts quality of life. JPGN Rep. 2021;2(3):e074. doi:10.1097/PG9.0000000000000074