Digestive Diseases and Sciences

, Volume 47, Issue 9, pp 2082–2087

Psychological Dimensions of Celiac Disease: Toward an Integrated Approach

  • Carolina Ciacci
  • Alessandro Iavarone
  • Monica Siniscalchi
  • Rita Romano
  • Antonio De Rosa


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.

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


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Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Carolina Ciacci
    • 1
  • Alessandro Iavarone
    • 2
  • Monica Siniscalchi
    • 3
  • Rita Romano
    • 1
  • Antonio De Rosa
    • 4
  1. 1.Cattedra di GastroenterologiaUniversità di Napoli “Federico II”NaplesItaly
  2. 2.Divisione di Neurologia–Ospedale CTO, Azienda Sanitaria Locale Napoli 1, Naples, Italy. Corso di Laurea in PsicologiaII Università di NapoliNaples, Italy
  3. 3.Corso di Laurea in PsicologiaII Università di NapoliNaplesItaly
  4. 4.Servizio di PsicoterapiaSeconda Università di NapoliNaplosItaly

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