Anxiety but not depression decreases in coeliac patients after one-year gluten-free diet: A longitudinal study

Background: A high prevalence of anxiety and depression has been reported i n untreated coeliac disease (CD) patients. At present, the role of a gluten -free diet (GFD) on psychological disorders is still poorly known. The aim of this study was to evaluate state and trait anxiety and depression in adu lt CD patients before and after 1 year of GFD. Methods: A total of 35 CD pa tients were studied before and after 1 year of GFD. A total of 59 healthy s ubjects matched for gender, age and socio-economic status were studied as a control group. State and trait anxiety were assessed with the STAI test: d epression was assessed using the modified version of the SDS Zung self-rati ng depression scale (M-SDS). The tests were administered before (TO) and af ter 1 year of GFD (T1). Results: At T0, CD patients showed high levels of s tate anxiety in a significantly higher percentage compared to controls (71. 4% versus 23.7%; P < 0.0001), while there was no significant difference in trait anxiety between groups (25.7% versus 15.2%; P:ns); the percentage of subjects with depression was significantly higher in the CD group than in t he control group (57.1% versus 9.6%: P < 0.0001). At T1. a significant decr ease in the percentage of state anxiety was found in CD patients (T0: 71.4% versus T1: 25.7%; P < 0.001), while there were no significant changes in t he percentage of trait anxiety (T0: 25.7% versus T1: 17.1%; P:ns) or depres sion (T0: 57.1.% versus T1: 45.7%: P:ns). which was still present in a sign ificantly higher percentage in treated CD compared to controls (P < 0.0001) . Conclusion: In CD patients anxiety is present in a predominantly reactive form and it decreases after GFD. Depression is present in a higher percent age in CD patients and 1 year of GFD fails significantly to affect depressi ve symptoms. The presence of depression after GFD could be related to the r eduction in quality of life in CD patients. The non-regression of depressio n after GFD could suggest that these patients need psychological support.